This article is more than 5 years old. Information may no longer be current.
BRCA mutations in women with ovarian cancer correlated with longer survival
Click Here to Manage Email Alerts
Ashkenazi women with ovarian cancer who had the BRCA1 or BRCA2 mutations had improved long-term survival compared with women without the mutations, according to Israeli researchers.
According to Noah D. Kauff, MD, a geneticist and gynecologist at Memorial Sloan-Kettering Cancer Center, this study is one of several that shows the mutations are associated with improved long-term survival in ovarian cancer.
|
|
Kauff wrote an editorial that accompanied the study results, which were published in the Journal of Clinical Oncology.
“There appears to be unique chemotherapy sensitivity in BRCA-associated tumors,” Kauff told HemOnc Today. “This property may allow us to pick chemotherapeutic agents that are more appropriate and also opens up the opportunity for targeted therapies in these patients.”
Increased survival
The case-control study was conducted in Israel between 1994 and 1999. Women with epithelial invasive ovarian cancer (n=779) were followed until 2003. Of the 605 Ashkenazi women, 35% had a BRCA1 or BRCA2 mutation.
Women with mutations had a significantly longer median survival: 53.7 months vs. 37.9 months in women without mutations. Women with mutations who had stage III or stage IV disease or poor grade also had a significant survival benefit.
The results were significant after controlling for age at diagnosis, grade and morphology. During the study period (with a median follow-up of 6.2 years), having a BRCA1 or BRCA2 mutation decreased the mortality rate by 28%.
Speculation on mechanism
According to Maurie Markman, MD, vice president for clinical research at the University of Texas M.D. Anderson Cancer Center and Gynecologic Cancers Section Editor for HemOnc Today, this mutation could cause the same result in both normal and cancer cells: the inability of the cells to repair DNA damage.
“In normal cells, the mutation leads to cell damage and causes cancer,” Markman said in an interview. “But the hypothesis is that the same mutation impairs a cancer cell’s ability to repair damage done by chemotherapy. Though not necessarily correct, it is logical and the data are increasingly indicating that it is correct.”
Markman said the hypothesis is that there are other repair mechanisms in normal cells but not in cancer cells. Thus, chemotherapy has a more potent effect on cancer cells. – by Emily Shafer