Germline BRCA1/2 mutação (gBRCAm) câncer de mama (HER2-negativo, ~5-10% de metastático): o...
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| ID | BMA-HRD-STATUS-BREAST |
|---|---|
| Tipo | Relevância terapêutica |
| Estado | reviewed 2026-04-27 | pending_clinical_signoff | actionability review required |
| Doenças | DIS-BREAST |
| Fontes | SRC-CIVIC SRC-ESMO-BREAST-EARLY-2024 SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Fatos de ação
| Biomarcador | BIO-HRD-STATUS |
|---|---|
| Variante | germline BRCA1/2 (gBRCA) — primary FDA companion biomarker; somatic BRCA1/2 also actionable; broader HRD-genomic signatures investigational |
| Doença | DIS-BREAST |
| Nível ESCAT | IA |
| Combinações recomendadas | olaparib monotherapy (gBRCAm HER2-negative metastatic per SRC-NCCN-BREAST-2025, SRC-ESMO-BREAST-METASTATIC-2024), talazoparib monotherapy (gBRCAm HER2-negative metastatic per SRC-NCCN-BREAST-2025), olaparib 1y adjuvant (gBRCAm high-risk early breast post-(neo)adjuvant chemo per SRC-NCCN-BREAST-2025, SRC-ESMO-BREAST-EARLY-2024) |
| Resumo das provas | Germline BRCA1/2 mutation (gBRCAm) breast cancer (HER2-negative, ~5-10% of metastatic): olaparib monotherapy is FDA-approved 2L+ for gBRCAm HER2-negative metastatic breast cancer based on OlympiAD (Robson NEJM 2017 — mPFS 7.0 vs 4.2 mo, HR 0.58); talazoparib monotherapy is FDA-approved on similar criteria (EMBRACA Litton NEJM 2018 — mPFS 8.6 vs 5.6 mo, HR 0.54) per SRC-NCCN-BREAST-2025, SRC-ESMO-BREAST-METASTATIC-2024. In the adjuvant setting, olaparib for 1y is FDA-approved for gBRCAm HER2-negative high-risk early breast cancer based on OlympiA (Tutt NEJM 2021 — IDFS HR 0.58, OS HR 0.68) per SRC-NCCN-BREAST-2025, SRC-ESMO-BREAST-EARLY-2024. |
Notas
ESCAT IA / OncoKB Level 1 (gBRCAm). Somatic BRCA mutations and broader HRD-genomic signatures (Myriad MyChoice CDx) have less consistent evidence in breast — current FDA-companion is BRACAnalysis CDx for gBRCAm. ESMO 2024 advanced breast guidelines flag PARP-i is preferred 2L over CDK4/6 sequencing in gBRCAm/HR+ metastatic when available. Bibliographic records SRC-OLYMPIA-TUTT-2021, SRC-OLYMPIAD-ROBSON-2017, and SRC-EMBRACA-LITTON-2018 are available; claim-level linkage requires clinical sign-off.
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