Researchers at the University of Cambridge have found a groundbreaking way to improve survival rates for patients with aggressive, inherited forms of breast cancer.
In a new study, patients with early-stage breast cancer linked to BRCA1 and BRCA2 gene mutations showed remarkable survival rates after receiving a new combination of treatments. Every patient who received this new approach survived for at least three years after surgery, marking a significant step forward in breast cancer treatment.
The study, known as the Partner trial, was led by Addenbrooke’s Hospital, part of Cambridge University Hospitals (CUH) NHS Foundation Trust, and the University of Cambridge. The results were published in Nature Communications. This trial introduced two major changes to the way these cancers are treated.
First, patients were given chemotherapy followed by a targeted cancer drug called olaparib before surgery, rather than the usual approach of starting olaparib after surgery. Second, the trial introduced a 48-hour gap between chemotherapy and olaparib, allowing the bone marrow time to recover while still leaving the cancer cells vulnerable to attack.
The BRCA1 and BRCA2 genes are well-known for their connection to breast cancer. When these genes are faulty, they fail to repair DNA damage properly, leading to a much higher risk of cancer. This condition gained public attention in 2013 when actress Angelina Jolie revealed that she carried the BRCA1 gene mutation and chose to undergo a preventative double mastectomy to reduce her cancer risk.
Traditional treatment for breast cancer with BRCA mutations involves chemotherapy to shrink the tumor, followed by surgery to remove it, sometimes combined with immunotherapy. The critical period for patients is the first three years after surgery when the risk of cancer returning or spreading is highest.
In the Partner trial, the strategy was different. Patients took olaparib—a targeted cancer drug available on the NHS—as tablets before surgery, alongside chemotherapy. Olaparib is designed to stop cancer cells from repairing their DNA, making them more likely to die off. By giving it before surgery, doctors hoped to weaken the tumor further before removal.
The results were impressive. Of the 39 patients who received this combination, only one experienced a relapse three years after surgery, and all survived the critical three-year period.
In contrast, of the 45 patients who only received chemotherapy, nine relapsed, and six passed away. This translates to a 100% survival rate for the new treatment compared to 88% for the traditional method.
Researchers believe the key to the success was the carefully timed gap between treatments. The 48-hour break allowed the bone marrow to recover from the harsh effects of chemotherapy, while the cancer cells, still damaged, remained vulnerable to olaparib.
This discovery came from a casual discussion between Professor Jean Abraham, the lead of the trial, and Mark O’Connor, AstraZeneca’s chief scientist in Early Oncology R&D. Their idea to test this gap turned out to be a critical part of the treatment’s success.
The findings from the Partner trial suggest that this approach could be extended to other cancers linked to BRCA mutations, including ovarian, prostate, and pancreatic cancers. If proven effective in larger trials, this method could become a standard treatment, providing new hope for patients with these aggressive cancers.
There could also be benefits for the healthcare system. Currently, patients take olaparib after surgery for up to a year, but the trial only required patients to take it for 12 weeks before surgery. This change could lower costs for the NHS and reduce side effects for patients.
Professor Abraham expressed her excitement about the results, noting that achieving a 100% survival rate in a trial for such aggressive cancers is rare. She emphasized that finding new, effective treatments for BRCA-related cancers is crucial, as these cancers are often harder to treat.
Mark O’Connor from AstraZeneca added that the study shows the importance of timing in cancer treatment and how understanding the biology of bone marrow recovery can lead to better outcomes.
Michelle Mitchell, the Chief Executive of Cancer Research UK, also praised the findings, calling them an important step in finding better ways to treat aggressive cancers. She noted that while the research is still early, it offers hope for extending patients’ lives and improving their quality of life.
The next phase of research will aim to confirm these results in a larger group of patients. The team also plans to explore if this new method could be less toxic than current treatments and more cost-effective. If successful, this approach could change the way aggressive, inherited breast cancers are treated, providing patients with a better chance at recovery and a longer, healthier life.
The Partner trial’s findings are not just a promising step for treating BRCA-related breast cancers but may also reshape how doctors think about the timing and combination of cancer treatments. If confirmed in larger studies, this could become a standard practice, offering patients new hope and better outcomes.
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The research findings can be found in Nature Communications.
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