U.K. researchers have found that patients with hereditary ovarian cancer – whose tumors are caused by faulty BRCA1 or BRCA2 genes – are more likely to experience metastases of the liver, lung, spleen, and viscera. … [T]he researchers suggest that ovarian cancer patients whose tumors spread to the solid organs … should be tested for the faulty genes – BRCA1 and BRCA2 – to ensure they are given the most appropriate treatment.
U.K. researchers have found that patients with hereditary ovarian cancer – whose tumors are caused by faulty BRCA1 or BRCA2 genes – are more likely to experience metastases of the liver, lungs, spleen, and viscera. This is despite the fact that their overall prognosis is better than other ovarian cancer patients. The research is published in the April 20th online edition of the Journal of Clinical Oncology.
In the study, researchers discovered that the percentage of women with BRCA1 or BRCA2 gene mutations who experienced visceral, liver, lung, and splenic metastases were 58%, 42%, 16%, and 32% , respectively, as compared with 5%, 0%, 0%, and 3%, respectively, in non-BRCA gene deficient women. The researchers note that sporadic (i.e., non-hereditary) ovarian tumors tend to remain within the lining of the abdomen and pelvis.
Based upon the study findings, the researchers suggest that ovarian cancer patients whose tumors spread to the solid organs such as the liver, lungs, and spleen should be tested for the faulty genes – BRCA1 and BRCA2 – to ensure they are given the most appropriate treatment. For example, patients with hereditary tumors, which account for 10 per cent of ovarian cancers, may be suitable for trials of a new drug called olaparib [AZD2281], which has fewer side-effects than normal cancer treatments. Olaparib belongs to a class of drugs known as “PARP” (Poly (ADP-ribose) polymerase) inhibitors.
Researchers say the study findings will improve the detection of faulty BRCA genes, as current criteria for genetic testing may miss as many as two-thirds of ovarian cancer patients carrying the mutated genes. Improving the identification of BRCA mutations will help relatives of ovarian cancer patients, who may themselves be at increased risk of developing hereditary ovarian cancer.
Dr. Charlie Gourley, who led the research at the University of Edinburgh, said:
“We are beginning to understand the importance of tailoring cancer treatments according to the specifics of each patient’s tumor. These findings demonstrate that tumors which arise because of defects in the BRCA1 or BRCA2 genes behave differently to other ovarian cancers. This information should also help us to identify the patients carrying these genetic mutations, give them the most effective treatment for their cancer and offer their relatives genetic counselling.”
- Gourley C, Michie CO, Roxburgh P, et. al. Increased Incidence of Visceral Metastases in Scottish Patients With BRCA1/2-Defective Ovarian Cancer: An Extension of the Ovarian BRCAness Phenotype. J Clin Oncol. 2010 Apr 20. [Epub ahead of print] PMID: 20406939.
- Fong PC, Yap TA, Boss DS, et. al. Poly(ADP)-Ribose Polymerase Inhibition: Frequent Durable Responses in BRCA Carrier Ovarian Cancer Correlating With Platinum-Free Interval. J Clin Oncol. 2010 Apr 20. [Epub ahead of print] PMID: 20406929.
- Fong PC, Boss DS, Yap TA, et. al. Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med. 2009 Jul 9;361(2):123-34. Epub 2009 Jun 24. PMID: 19553641 (full article text available at New England Journal of Medicine).