{"entity":{"id":"germline-to-parp","kind":"pairing","name":"Germline BRCA test → adjuvant PARP inhibitor","aka":[],"tldr":"A blood test for inherited BRCA mutations unlocks a year of olaparib after surgery, which improves survival.","summary":"This diagnostic-therapeutic pairing links Germline (hereditary) testing for inherited BRCA1 / BRCA2 (HRD) mutations to a year of adjuvant Olaparib, one of the PARP inhibitors, after surgery. The rationale is synthetic lethality confined to BRCA-deficient cells, so the drug is only worth giving once the inherited mutation is confirmed. The phase 3 OlympiA trial showed that adjuvant olaparib improved invasive disease-free survival and overall survival in this population. Because the treatment depends on the test, every patient with Triple-negative breast cancer (TNBC) or high-risk HR-positive / HER2-negative breast cancer needs germline testing at diagnosis, which is why the pairing is linked from the TNBC and Germline testing entries.","asOf":"2026-09-04","links":[{"label":"ClinicalTrials.gov NCT02032823: OlympiA","url":"https://clinicaltrials.gov/study/NCT02032823"}],"tags":[],"related":[],"cancers":["tnbc","breast-hr-positive"],"sections":[],"technologies":[],"targets":["brca"],"drugs":["olaparib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["olympia"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"germline-testing","b":"parp-inhibitor","rationale":"Synthetic lethality confined to BRCA-deficient cells.","evidence":"Phase 3 OS benefit.","pairingType":"diagnostic-therapeutic"},"route":"/pairings/germline-to-parp/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"target":[{"id":"brca","kind":"target","name":"BRCA1 / BRCA2 (HRD)","route":"/targets/brca/"}],"drug":[{"id":"olaparib","kind":"drug","name":"Olaparib","route":"/drugs/olaparib/"}],"trial":[{"id":"olympia","kind":"trial","name":"OlympiA","route":"/trials/olympia/"}],"technology":[{"id":"germline-testing","kind":"technology","name":"Germline (hereditary) testing","route":"/technologies/germline-testing/"},{"id":"parp-inhibitor","kind":"technology","name":"PARP inhibitors","route":"/technologies/parp-inhibitor/"}],"roadmap":[{"id":"pancreatic-roadmap","kind":"roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","route":"/roadmaps/pancreatic-roadmap/"},{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}],"idea":[{"id":"idea-pdac-surveillance-for-every-germline-carrier","kind":"idea","name":"Surveillance for every germline carrier found by universal testing, inside a registry rather than a research exception","route":"/ideas/idea-pdac-surveillance-for-every-germline-carrier/"}]}}