In the era of precision medicine, targeted therapies are proving effective against many different type of cancers. Notably, the PARP inhibitors have been approved in several countries for multiple indications in ovarian, breast, prostate, and pancreatic cancers, offering significant benefits for patients. These therapies can help extend life expectancy, improve disease-free survival rates, and enhance overall patient survival.

In Vietnam, breast cancer is the most common cancer in women, with more than 24,000 new patients and more than 10,000 deaths annually (according to Globocan 2022)¹. Data show that nearly 70% of cases are diagnosed in the early stages. However, 20-30% of patients will progress or metastasise, especially in high-risk patient groups with clinical characteristics such as young age, large tumour, positive lymph nodes, high histological grade, and BRCA1/2 gene mutation. Among these, BRCA1/2 gene mutation is associated with specific clinical features, a worse clinical course, and poor treatment outcomes. Therefore, treatment needs to be individualised to improve overall patient survival²˒³˒⁴.

For men, prostate cancer is the 5th most common cancer in Vietnam, with more than 5,800 new patients and 2,800 deaths annually1. Metastatic castration-resistant prostate cancer (mCRPC) is a disease with a poor, heterogeneous prognosis and often leads to death.

The workshop updated the latest clinical data showing the role of PARP inhibitors in 2 patient groups: early-stage breast cancer, HER2 negative, with hereditary BRCA1/2 mutations and breast cancer. Metastatic castration-resistant prostate cancer has no indication for chemotherapy.

Emphasising the importance of of BRCA1/2 gene mutation testing in early stage breast cancer patients group, Associate Professor, PhD. Phung Thi Huyen, Head of Internal Medinicine Department 6, K Hospital said "Testing for BRCA 1/2 gene mutations is an important step to help surgeons and internists have a comprehensive patient management plan, including decision-making. Determine the type of surgery and medical treatment. For patients with early-stage, high-risk breast cancer who have inherited BRCA1/2 gene mutations, are HER2-negative, and have been treated with neoadjuvant or adjuvant chemotherapy, PARP inhibitors are an approved treatment option in Vietnam and are recommended by reputable associations”. Data from the OlympiA study showed that this high-risk patient group using Olaparib significantly prolonged overall survival and nearly 90% of patients were alive at 4 years of treatment. To date, OlympiA is the only study with clinical data showing a statistically significant survival improvement in patients with HER2-negative early breast cancer5.

The combination of new-generation endocrine therapy and PARP inhibitors from the first step in patients with castration-resistant prostate cancer has been demonstrated through clinical studies, including the PROpel study. The results showed that the group of patients using this combination had a progression-free survival time of up to more than 2 years, an increase of more than 8 months compared to the comparison group, and the overall survival time of the combination arm was over 42 months7.

This effect was consistent across different subgroups: based on HRR mutation status, metastasis status, symptoms, or prior chemotherapy treatment. Adverse events were all manageable and similar to the side effects of each drug, such as anemia, fatigue, nausea, or high blood pressure.

Associate Professor, Doctor, Senior Lecturer Lê Đình Khánh - Chairman of the Vietnam Urology - Nephrology Association - Chair of the seminar commented in the Prostate Cancer Discussion Session "In the metastatic castration-resistant prostate cancer stage, although patients still have some treatment options, the outcome remains poor and less than 50% of patients can receive further treatment at step 2. This situation highlights the need for aggressive treatment and effective selection at step 1. The results of the study support the combination of targeted therapy and new-generation endocrine drugs as the new standard of care for these patients”.

Committed to partnering with Vietnam's healthcare system for sustainable development and bringing life-changing treatments to the people and community, Mr. Atul Tandon - General Director of AstraZeneca Vietnam shared:

"Over the past 30 years in Vietnam, AstraZeneca has always strived to provide people with leading therapies for respiratory, digestive, cardiovascular, renal, and metabolic diseases, with a particular focus on oncology. Through ongoing collaboration with hospitals and medical organisations, we are proud to have positively impacted the lives of millions of patients, including those battling breast and prostate cancer. Embracing advancements in science in Breast and Prostate Cancers, AstraZeneca is dedicated to achieving significant improvements in treatment outcomes. Our ultimate ambition is to end cancer as a cause of death”.

In addition to seminar programmes connecting foreign speakers with leading Vietnamese experts, AstraZeneca has partnered with hospitals to provide high-quality molecular biology tests (HRD/HRR/BRCA) for over 1,300 patients and support the establishment of genetic counselling units. To alleviate the financial burden of treatment costs, AstraZeneca is working closely with hospitals and the Ministry of Health to gain approval for drug support programs. After each cycle of self-funded treatment, patients can receive free support for the next 1-2 cycles of treatment, making targeted therapies accessible to more cancer patients in Vietnam.