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BRCA2 mutation associated with shorter survival in screen-detected prostate cancer
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Men with screen-detected prostate cancer who harbor mutations in the BRCA2 gene demonstrated poorer-than-expected prognosis, according to study results.
Prior research has demonstrated that BRCA2 mutations are associated with increased risk for prostate cancer, but the effect of the mutation on mortality is not known.
Steven Narod, MD, FRCPC, FRSC, director of the Familial Breast Cancer Research Unit at Women’s College Research Institute, and colleagues genotyped 4,187 Canadian men who underwent prostate biopsy due to an abnormal screening test between 1998 and 2010.
Researchers screened the BRCA2 genes of all men, then followed all men for death from prostate cancer until December 2012.
Biopsy results indicated 45.5% of men were diagnosed with prostate cancer. The 54.5% of participants who did not receive a prostate cancer diagnosis served as controls.
Researchers detected BRCA2 mutations in 1.4% of cases and 0.4% of controls, equating to a highly significant OR of 3.5.
Mean follow-up was 8.7 years.
Among men diagnosed with prostate cancer, those who carried BRCA2 mutations were more likely to be older (67 years vs. 65 years), have a higher average PSA concentration at diagnosis (56.3 ng/mL vs. 13.3 ng/mL) and have high-grade disease (96% vs. 54%).
In the prostate cancer cohort, 73% of men who carried BRCA2 mutations were alive at last follow-up compared with 96% of non-carriers. Researchers reported 12-year prostate cancer-specific survival rates of 61.8% among BRCA2 mutation carriers and 94.3% among non-carriers (P<10-4)
After researchers adjusted for confounders, they determined presence of a BRCA2 mutation was associated with an HR of 3.48 for prostate cancer-specific mortality. The HR increased to 4.38 among men with high-grade disease.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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