medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-9-179-184medsovet-6931Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONОпыт применения олапариба у пациентки с люминальным HER2neu-позитивным метастатическим раком молочной железыExperience with olaparib in a patient with luminal HER2-positive metastatic breast cancerhttps://orcid.org/0000-0003-4879-2687БолотинаЛ. В.BolotinaL. V.

Болотина Лариса Владимировна – доктор медицинских наук, заведующая отделением химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 2787-5414

Larisa V. Bolotina - Dr. Sci. (Med.), Head of the Chemotherapy Department, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

lbolotina@yandex.ruhttps://orcid.org/0000-0003-0092-0459КорниецкаяА. Л.KornietskayaA. L.

Корниецкая Анна Леонидовна – кандидат медицинских наук, ведущий научный сотрудник отдела лекарственного лечения опухолей.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 2651-7158

Anna L. Kornietskaya - Cand. Sci. (Med.), Leading Researcher of the Department of Drug Treatment of Tumors, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

kornietskaya@mail.ruhttps://orcid.org/0000-0001-5530-3234КачмазовА. А.KachmazovA. A.

Качмазов Андрей Александрович - младший научный сотрудник отдела лекарственного лечения опухолей.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 7547-7725

Andrei A. Kachmazov - Junior Researcher of the Department of Drug Treatment of Tumors, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

andrewkachmazov@gmail.comhttps://orcid.org/0000-0002-6244-9159ПризоваН. С.PrizovaN. S.

Призова Наталия Сергеевна - кандидат медицинских наук, врач-онколог отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 9563-3579

Natalia S. Prizova - Cand. Sci. (Med.), Oncologist of the Chemotherapy Department, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

sonrisa3n@mail.ruhttps://orcid.org/0000-0001-7912-8055ПайчадзеА. А.PaichadzeA. A.

Пайчадзе Анна Александровна - кандидат медицинских наук, научный сотрудник отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 7492-2030

Anna A. Paichadze - Cand. Sci. (Med.), Researcher of the Department of Chemotherapy, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

paiann@mail.ruhttps://orcid.org/0000-0002-2061-0522УстиноваТ. В.UstinovaT. V.

Устинова Татьяна Васильевна - кандидат медицинских наук, сотрудник отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 3638-0120

Tatiana V. Ustinova - Cand. Sci. (Med.), Employee of the Chemotherapy Department, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

t.v.rafeyenko@gmail.comhttps://orcid.org/0000-0002-3371-7548ДешкинаТ. И.DeshkinaT. I.

Дешкина Татьяна Игоревна - кандидат медицинских наук, старший научный сотрудник отделения химиотерапии.

125284, Москва, 2-й Боткинский проезд, д. 3.

SPIN-код: 5950-5474

Tatiana I. Deshkina - Cand. Sci. (Med.), Senior Researcher of the Department of Chemotherapy, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

SPIN-code: 2787-5414

rew9@yandex.ruhttps://orcid.org/0000-0002-1993-3842ЕвдокимоваС. Ф.EvdokimovaS. F.

Евдокимова Сэвиндж Физулиевна – аспирант.

125284, Москва, 2-й Боткинский проезд, д. 3.

Sevindzh F. Evdokimova - Postgraduate Student, Hertsen Moscow Oncology Research Institute.

3, 2nd Botkinskiy Proezd, Moscow, 125834.

evdokimova.sevindzh@gmail.comМосковский научно-исследовательский онкологический институт имени П.А. ГерценаРоссияHertsen Moscow Oncology Research InstituteRussian Federation20221906202209179184Copyright © Болотина Л.В., Корниецкая А.Л., Качмазов А.А., Призова Н.С., Пайчадзе А.А., Устинова Т.В., Дешкина Т.И., Евдокимова С.Ф., 20222022Болотина Л.В., Корниецкая А.Л., Качмазов А.А., Призова Н.С., Пайчадзе А.А., Устинова Т.В., Дешкина Т.И., Евдокимова С.Ф.Bolotina L.V., Kornietskaya A.L., Kachmazov A.A., Prizova N.S., Paichadze A.A., Ustinova T.V., Deshkina T.I., Evdokimova S.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6931

На долю наследственного рака молочной железы (РМЖ) приходится порядка 5-10% случаев. BRCA-ассоциированные опухоли выделены в отдельную группу злокачественных новообразований (ЗНО) с характерными клиническими проявлениями и особенностями лечения. Понимание биологических механизмов, приводящих к возникновению ЗНО у носителей мутаций в генах BRCA1/2, и обнаружение потенциальных молекулярных мишеней, таких как поли (АДФ-рибоза) полимераза (PARP), участвующих в механизмах эксцизионной репарации оснований, привело к появлению нового класса таргетных препаратов, относящихся к группе PARP-ингибиторов. Ингибирование PARP приводит к сохранению одноцепочечных разрывов ДНК, остановке репликационной вилки и реализации феномена «синтетической летальности» в связи с невозможностью восстановления двухцепочечных разрывов ДНК путем гомологичной рекомбинации в клетках с мутациями в генах BRCA1/2. В двух рандомизированных исследованиях OlympiAD и EMBRACA была оценена и доказана эффективность PARP-ингибиторов у больных с метастатическим BRCA-мутированным HER2neu-негативным РМЖ в сравнении со стандартной химиотерапией. В то же время данные о возможностях применения ингибиторов PARP для лечения пациентов BRCA-мутированным HER2neu-позитивным РМЖ крайне ограничены. В данной статье представлен клинический пример применения олапариба у пациентки с BRCA-мутированным HER2neu-позитивным метастатическим РМЖ.

Hereditary breast cancer (BC) accounts for about 5-10% of cases. BRCA-associated tumors have been identified as a separate group of malignant neoplasms with distinctive clinical manifestations and specific treatment features. Understanding of biological mechanisms leading to cancer in BRCA1/2 mutation carriers and discovery of potential molecular targets, such as poly (ADP-ribose) polymerase (PARP), involved in base excision repair mechanisms, led to the development of a new class of targeted drugs belonging to the PARP inhibitors group. PARP inhibition leads to the preservation of single-stranded DNA breaks, the arrest of the replication fork, and the realization of the “synthetic lethality” phenomenon due to the inability to repair double-stranded DNA breaks by homologous recombination in cells with mutations in the BRCA1/2 genes. Two randomized trials OlympiAD and EMBRACA evaluated and proved the effectiveness of PARP inhibitors in patients with metastatic BRCA-mutated HER2-negative breast cancer in comparison with standard chemotherapy. At the same time, data on the potential use of PARP inhibitors for the treatment of BRCA-mutated HER2-positive breast cancer patients are extremely limited. This article presents a clinical example of the use of olaparib in a patient with BRCA-mutated HER2-positive metastatic breast cancer.

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The authors declare that there are no conflicts of interest present.