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NCCN Guideline updates in early-stage breast cancer: what every patient needs to know

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The National Comprehensive Cancer Network (NCCN)® is a not-for-profit alliance of 31 leading cancer centers devoted to patient care, research and education. The NCCN publishes treatment guidelines for each cancer type and routinely updates these guidelines based on new FDA approvals and the latest scientific evidence. Recently, the NCCN updated their Breast Cancer Clinical Practice Guidelines® for physicians to include two new treatment options for early-stage breast cancer, with the most recent update released earlier this week on August 16, 2021. Outcomes4Me has updated its breast cancer app in order to make these guideline changes easily accessible to patients.

Two new treatment options for stage 2 and 3 breast cancer patients:

  • The immunotherapy, pembrolizumab (Keytruda, Merck) for triple negative patients.
  • The PARP inhibitor targeted therapy, olaparib (Lynparza, Astrazeneca) for BRCA-positive HER2-negative patients .

What you need to know about the immunotherapy, Pembrolizumab:

The FDA approved last month pembrolizumab in the preoperative setting for stage 2-3 triple negative breast cancer. Pembrolizumab is the first immunotherapy drug approved for treating early-stage triple negative breast cancer. Pembrolizumab is given in combination with chemotherapy before surgery and alone after surgery. The FDA approval of pembrolizumab is based on data from the Phase 3 Keynote-522 trial. This trial found that taking pembrolizumab plus chemotherapy followed by adjuvant pembrolizumab as monotherapy showed a statistically significant and clinically meaningful improvement in event-free survival (EFS) compared with neoadjuvant chemotherapy alone.

What you need to know about the PARP inhibitor targeted therapy, Olaparib:

Olaparib is now recommended for high-risk, early-stage, BRCA-positive HER2-negative breast cancer based on data from the Phase 3 OlympiA trial. Olaparib has previously shown to be effective in treating BRCA-mutated metastatic breast cancer. Focusing now on early-stage cancer, researchers in the OlympiA study prescribed 1 year of olaparib or placebo following surgery and standard chemotherapy. The study found that 85.9% of patients taking olaparib did not experience recurrence or a secondary cancer after three years as compared to 77.1% of patients who received chemotherapy alone.

Based on the newest olaparib recommendations, more patients should be assessed for germline BRCA1/2 mutations through genetic testing to learn if olaparib could be a treatment option. Stay tuned for the Outcomes4Me app updates to the NCCN Guidelines® for Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic guidelines to see if you meet criteria for genetic testing.

To learn more about your latest treatment options as it relates to the latest NCCN Guidelines® download the Outcomes4Me app today.


Schmid, Peter, et al. “Pembrolizumab for Early Triple-Negative Breast Cancer.” New England Journal of Medicine, vol. 382, no. 9, 2020, pp. 810–821., doi:10.1056/nejmoa1910549.

Tutt, Andrew N.J., et al. “Adjuvant Olaparib for Patients WITH brca1- Or BRCA2-MUTATED Breast Cancer.” New England Journal of Medicine, vol. 384, no. 25, 2021, pp. 2394–2405., doi:10.1056/nejmoa2105215.

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