TUESDAY, Jan. 24 (HealthDay News) -- Genetic mutations known as
BRCA1 and BRCA2 raise the risk of getting ovarian cancer, but new
research shows that those same mutations may boost a woman's odds
of surviving the deadly disease.
Women with invasive epithelial ovarian cancer who carry the
mutations have a better prognosis than women without the genetic
variations, according to an analysis of 26 previous studies. The
BRCA2 carriers, in particular, had a better five-year survival
rate.
"Our paper provides definitive evidence that BRCA1 and BRCA2 carriers have improvement in survival [compared to ovarian cancer patients without the mutations]," said Kelly L. Bolton, lead author of the new analysis and a medical student at the University of California, Los Angeles, David Geffen School of Medicine.
The study, which confirms previous findings, is published Jan.
25 in the
Journal of the American Medical Association.
Nearly 23,000 women will get a diagnosis of ovarian cancer this
year in the United States, and about 15,500 will die of it,
according to the American Cancer Society. Epithelial ovarian
cancer, the type Bolton focused on, occurs in the cells on the
surface of the ovary.
Germline BRCA1 and BRCA2 mutations are found in up to 15 percent
of women with this type of cancer. A germline mutation is a gene
change in a reproductive cell that can be passed on to
offspring.
Data from more than 1,213 ovarian cancer patients was included
in the studies reviewed. Of these, 909 had BRCA1 mutations; 304 had
BRCA2 variations.
The studies also included 2,666 women who did not have the
genetic mutations.
At the five-year mark, 44 percent of the BRCA1 carriers and 52
percent of the BRCA2 carriers were alive, compared to 36 percent of
those without the mutation.
Bolton said the survival differences remained after the
researchers took into account such factors as the stage of the
cancer and age, although it was less significant among women with a
family history of ovarian and/or breast cancer.
Exactly how the mutations may improve survival is not known.
However, Bolton and others speculate the BRCA1 or BRCA2 status may
modify the response to platinum-based chemotherapy, a common
treatment.
The new analysis will have important implications for future
research and treatment of ovarian cancer, the authors said. Routine
genetic screening of women with high-grade cancer might be
warranted, they added.
Dr. Elizabeth Poynor, a gynecologic oncologist and pelvic
surgeon at Lenox Hill Hospital in New York City, suggested the
findings can help health care providers tailor treatment and more
accurately counsel them regarding expected survival.
While not new, the information is valuable, Poynor said. "For a
long time, we've known that individuals with BRCA1 or 2 actually
have a better prognosis," she said. "This is not new information,
it's expanded information. It's reinforcing what we already
know."
More research is needed, the authors said, acknowledging some
study limitations. For instance, the analysis lacked complete
information on types of chemotherapy used, which might also have
influenced survival.
Some co-authors reported consultancy fees from Complete Genomics
Inc., a company engaged in gene sequencing, and from Merck Sharp
& Dohme, Roche, Schering-Plough, Pfizer and other
pharmaceutical firms.
More information
Learn how ovarian cancer is diagnosed at the
American Cancer Society.