BRCA May Not Impact Survival in Young-Onset Breast Cancer


USA regulators have approved the first drug to treat women with advanced breast cancers caused by the same flawed gene that Angelina Jolie made famous.

With the decision aid, half of the women scored at least 80 out of 100 on tests of their knowledge about breast cancer and treatment options, compared with a median score of 66 for women who reviewed material on various websites.

The BRCA1 and BRCA2 gene mutations increase a woman's risk of breast cancer by four-to-eightfold.

The gene mutation has widely been dubbed the "Angelina Jolie gene" after the actress discovered she had an 87 per cent chance of developing cancer and underwent a preventative double mastectomy as a result.

"Our data provides some reassurance that patients who are diagnosed with a BRCA gene fault as part of their cancer treatment journey can complete and recover from their breast cancer treatment, which is important", she said.

Ellen R. Copson, Ph.D., from the University of Southampton in the United Kingdom, and colleagues conducted a prospective cohort study involving female patients recruited from 127 hospitals in the United Kingdom who were aged 40 years or younger at first diagnosis of invasive breast cancer.

Having a faulty BRCA gene - either BRCA1 or BRCA2 - is known to increase a woman's risk of breast cancer.

Despite the findings, the study authors caution that in the longer term, risk-reducing surgery should be discussed as an option for BRCA1 mutation carriers in particular, to minimise their future risk of developing a new breast or ovarian cancer.

Patients were then followed up for an average of just over 8 years, which revealed similar survival across women in the study, regardless of their BRCA status, the researchers report in the Lancet Oncology.

An expert said women should take time to decide if surgery was for them.

Clovis' PARP inhibitor Rubraca (rucaparib) was approved in the late 2016 for advanced ovarian cancer patients who have received at least two prior lines of chemo and whose tumors harbor the BRCA mutation.

After the women's medical records were tracked for up to ten years, researchers found that 651 of 678 total deaths were due to breast cancer.

The PARP inhibitor is now available to patients with deleterious or suspected germline BRCA-mutated (bBRCAm), human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (MBC) who have been previously treated with chemotherapy in the neoadjuvant, adjuvant or metastatic setting.

'However, our findings suggest that this surgery does not have to be immediately undertaken along with the other treatment.

This surgery did not appear to improve their chances of survival at the 10-year mark. "Decisions about timing of additional surgery to reduce future cancer risks should take into account patient prognosis after their first cancer, and their personal preferences".