A new large-scale study appears to confirm that prostate cancer patients with mutations in the BRCA2 gene are likely to have more aggressive and rapid progression of the disease, and to have worse survival outcomes.
Certain mutations in the BRCA genes are well known to be strong determinants of particularly penetrant and aggressive forms of inherited breast and ovarian cancer, but are also associated with increased risk of developing any invasive cancer, including prostate cancer.
The research published in the Journal of Clinical Oncology looked at more than 2000 men with prostate cancer including 18 with a BRCA1 mutation, 61 with a BRCA2 mutation, and 1,940 with neither mutation.
It found that for patients with mutations in either of the BRCA genes the cancer was more likely to have already metastasised at diagnosis, to develop at a faster rate, and to approximately halve expected survival time following diagnosis (6.5 years compared with nearly 13 years). The study authors were only able to confirm their findings in the BRCA2 patients however, due to limitations in the BRCA1 group size and their availability for follow-up.
The researchers conclude that prostate cancer patients with BRCA1/2 mutations should be considered for tailored and more aggressive clinical management than non-carriers, perhaps with surgical intervention even when diagnosed at an early stage when this would not ordinarily be thought necessary. CRUK’s Senior Science Communication Manager, Dr Julie Sharp said "This study shows that doctors need to consider treating men with prostate cancer and a faulty BRCA2 gene much sooner than they currently do, rather than waiting to see how the disease develops”.