Healthcare

A new study suggested that women with sporadic ovarian cancer and BRCA/ germline mutations have higher risk for visceral metastases.

Reported on April 9th, 2010 in the Journal of Clinical Oncology, lead author, Dr. Charlie Gourle from University of Edinburgh, Scotland, and colleagues, said that the clinical implications of the findings are 2-fold.
First, the researchers advice clinicians to consider BRCA1/2 mutations in women with ovarian cancer who develop visceral metastases. This might inform genetic counseling for both the patient and her family, and it might also identify women who are eligible for trials of the poly ADP-ribose polymerase (PARP) inhibitor olaparib.

For the second, the researcher said that their data extend the BRCAness phenotype in ovarian cancer. It suggests that BRCA1/2-associated ovarian cancer is a discrete clinical entity, the behavior of which is different from most sporadic ovarian cancers.

The study involved 79 patients with Epithelial Ovarian Cancer/Primary Peritoneal Cancer (EOC/PPC) and 19 of them with BRCA1/2 mutations, 14 (74%) developed visceral metastases, compared to 6 (16%) of 38 matched control patients.

The comparison metastases in the BRCA1/2 mutation carriers vs matched control as following;
- the rates of liver metastases; 53% vs 5%,
- the rates of lung metastases; 32% vs 3%,
- the rates of splenic metastases; 32% vs 5%.

The researchers team reported, “This relationship is particularly strong for BRCA1 mutation carriers, 92% of whom developed visceral metastases compared with only 16% in our control group.”

The overall median follow-up for patients who remained alive without visceral metastases was 30 months.
After excluding events that occurred outside of the matched follow-up period, the frequency of all visceral, hepatic, pulmonary, and splenic metastases in BRCA1/2 mutation carrier was 58%, 42%, 16%, and 32%, respectively. All of these were significantly greater than in matched controls (range, 0% to 5%).

As their was a retrospective study, the researchers team point out that additional studies will be required to confirm this findings.