The FABULOUS trial demonstrates that combining fuzuloparib (a PARP inhibitor) with apatinib (an angiogenesis inhibitor) significantly improves progression-free survival compared to chemotherapy in women with BRCA1/2-mutated metastatic breast cancer. The three-arm Chinese study enrolled patients across 40 sites, comparing combination therapy, fuzuloparib monotherapy, and physician's choice chemotherapy. This represents a notable advance in precision oncology for hereditary breast cancer. PARP inhibitors exploit DNA repair deficiencies in BRCA-mutated tumors, while angiogenesis inhibitors starve tumors by blocking blood vessel formation. The combination approach addresses a longstanding question about whether dual-pathway targeting could overcome resistance mechanisms that limit single-agent PARP inhibitor effectiveness. Previous research suggested theoretical synergy between these drug classes, but clinical validation has been limited. For patients with BRCA mutations who exhaust standard treatments, this combination offers a potentially superior alternative to traditional chemotherapy. However, the findings require validation in diverse populations beyond the Chinese cohort, and the interim nature of results means long-term safety and overall survival data remain pending. The study's design comparing both combination and monotherapy arms provides valuable insights into whether the additional toxicity of dual therapy justifies the clinical benefit.