Advanced-stage ovarian cancer patients with BRCA live longer, may respond better to treatment

Two abstracts underscoring the importance of testing for BRCA1/2 mutations in women with ovarian cancer were presented at this week's Society of Gynecologic Oncologists 39th Annual Meeting on Women's Cancers, by researchers from The University of Texas M. D. Anderson Cancer Center.

In the first study, a multicenter research team led by M.D. Anderson found advanced- stage ovarian cancer patients with non-Ashkenazi Jewish BRCA (non-AJ BRCA) mutations experience longer progression-free and overall survival rates compared to those with sporadic ovarian cancer. The data confirms previous research which reported that among ovarian cancer patients of Ashkenazi-Jewish heritage, BRCA1/2 mutations (AJ BRCA) are associated improved long-term survival.

For this study, researchers examined 85 advanced-stage ovarian cancer patients with non-AJ BRCA mutations and 116 patients who did not express any type of BRCA mutation. Compared to patients without BRCA mutations, non-AJ BRCA carriers had longer progression-free survival of 19.0 vs. 27.8 months and improved overall survival of 65.6 vs. 101.4 months. Non-AJ BRCA patients had a 2.15 times greater odds of complete response to initial chemotherapy response over sporadic, non-carrier patients.

Karen Lu, M.D., associate professor in the Department of Gynecologic Oncology at M. D. Anderson and senior author on the study said the difference in survival rates indicate that individuals with BRCA mutations might respond better to standard chemotherapy for ovarian cancer. "Thus, it becomes increasingly valuable to know a patient's BRCA status to guide and personalize treatment decisions," Lu said.

Majority of Patients Unaware BRCA Testing Available

A second study conducted at M. D. Anderson concluded that, despite being available for more than 10 years, a majority of women with ovarian cancer were unaware genetic counseling and testing for BRCA1/2 mutations was an option. Of the 225 ovarian cancer patients surveyed, 56 percent had not heard of BRCA testing. This lack of awareness was more profound in minorities - 69 percent of Hispanic and 88 percent of African American respondents were unaware of BRCA testing compared to 52 percent of white women.

"Patients typically associate genetic testing with benefiting family members and offspring," Lu said. "Both of these studies illustrate that it is equally important for the cancer patient to get information from their doctors about genetic testing because it not only has implications for their family, but their own treatment and prognosis."

She said that more than 85 percent of ovarian cancer patients surveyed would be willing to undergo BRCA testing if it would affect their care, but the cost of testing may be a barrier. "Currently, oncologists are inconsistent in their testing for BRCA mutations. Based on the treatment implications of our findings and the surprisingly low knowledge that such testing is available, we recommend developing ways to systematically evaluate every ovarian cancer patient for BRCA," Lu said.

A family history of breast and/or ovarian cancer is reported in approximately five percent to 15 percent of ovarian cancer cases, with BRCA1/2 mutations expressed in a significant proportion of these cases.