Poly(ADP-Ribose) Inhibition: Exploring a New Approach to Breast Cancer Prevention in BRCA1/2 Mutation Carriers

Carriers of deleterious BRCA1 and BRCA2 mutations face an elevated risk of developing breast cancer. This risk warrants consideration of prevention interventions. Currently, the only proven prevention intervention for BRCA mutation carriers is risk-reducing surgery. Inhibitors of poly(ADP-ribose) polymerase (PARP) are a new class of drugs that appear to be effective in treating BRCA mutation–associated cancers and triple-negative breast cancers. PARP inhibitors may offer a new approach to breast cancer prevention in BRCA mutation carriers. This article reviews current breast cancer prevention interventions for BRCA mutation carriers and discusses the rationale for investigating new chemoprevention agents in this population. The mechanism of action of PARP inhibitors and the rationale for studying them in BRCA mutation carriers is reviewed. Published clinical trials regarding PARP inhibitors and ongoing research regarding PARP inhibitors and breast cancer prevention are reviewed.