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Real-world treatment patterns in 1954 US patients with HER2-negative early breast cancer and germline BRCA mutations (2021–2025)

Published

December 2025

Citation

Sardesai S, Ru M, Ma X, et al. Real-world treatment patterns in 1954 US patients with HER2-negative early breast cancer and germline BRCA mutations (2021–2025). SABCS. 2025.

Overview

This study investigated real-world treatment patterns in US patients with early-stage, HER2-negative breast cancer who have germline BRCA mutations (gBRCAm). The research aimed to understand the use of adjuvant olaparib, a PARP inhibitor, in this patient population, particularly focusing on how treatment decisions align with established criteria and the sequencing of therapies. 

Using data from Flatiron Health EHR-derived Panoramic database comprised of >940K patients with breast cancer, the team analyzed data on nearly 2,000 patients to describe demographics, clinical characteristics, and neoadjuvant/adjuvant treatment patterns across different tumor subtypes and disease risk statuses.

Why this matters

The findings reveal that over 40% of eligible patients with gBRCAm, high-risk HER2-negative breast cancer did not receive adjuvant olaparib, highlighting a critical gap in treatment uptake. The study also observed that real-world olaparib use extended beyond the high-risk criteria defined in the OlympiA trial, suggesting the need for broader risk assessments in clinical practice. These insights underscore the need for further research into long-term outcomes based on treatment choices, which can help optimize treatment plans and timing to ensure patients with gBRCAm early breast cancer receive the most effective care.

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