The overarching messages for physicians and researchers is that BRCA1 and BRCA2 are different mutations that can affect survival and how well medications work, he said. New drugs to treat ovarian cancer in the pipeline should avoid lumping the mutations together and instead study each individually, Yang said.
Dr. Victor Grann, a professor of medicine, epidemiology and health policy at Columbia University who wrote an accompanying editorial, noted that although BRCA1 and BRCA2 puts women at heightened risk of breast cancer, many women with the mutations will never go on to develop either cancer, or will die of other causes (such as old age) before developing cancer.
And though the study suggests that platinum-based chemo may be more effective in women with BRCA2, chemotherapy can still be effective in other women, Grann said. Of the 316 women in the study, 225 saw at least some benefit from chemotherapy.
New medications that are currently showing promise in clinical trials may also prove to be more effective in women with BRCA1 or BRCA2.
"The next step would be to enroll these patients in randomized clinical trials to test whether BRCA1 or BRCA2 mutation carriers respond differently with regard to ovarian cancer," Grann wrote in the editorial.
There are already other things known about differences between tumors in BRCA1 versus BRCA2 patients. Most breast cancer tumors in women with BRCA2 mutation are estrogen-receptor positive, meaning they respond better to drugs that interfere with the activity of estrogen or estrogen levels such as tamoxifen or aromatase inhibitors, while most BRCA1 cancers are estrogen-receptor negative, Grann said.
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