Mutations in the BRCA genes are infamous for increasing a woman’s risk for breast and ovarian cancer. For years, only women were referred to genetic counselling for these inherited mutations and took sometimes extensive cancer-preventative measures if they were carriers; Angelina Jolie publicly shared her story of undergoing prophylactic surgery in 2013. Male members of these families had no reason to be concerned about these mutations and their own health. Now all that is changing.
Recent research funded by the Prostate Cancer Foundation (PCF), the world’s leading philanthropic organization dedicated to funding life-saving prostate cancer research, has found that mutations in BRCA1, BRCA2, and related genes also cause prostate cancer and are responsible for 20 to 30 percent of advanced prostate cancer cases. In about half of these men, the mutations had been inherited. In the others, these mutations developed only in the tumor and caused it to progress. These findings have rapidly changed medicine in two very important ways.
New guidelines for genetic screening
National Comprehensive Cancer Network (NCCN) guidelines now recommend that all men with high risk, regional, or metastatic prostate cancer undergo genetic testing for inherited mutations in BRCA1/2 and related genes.
For men found to be carriers, this is critical information for their families. Mutations in these genes are associated with increased risk for ovarian, breast (female and male), prostate, pancreatic, and potentially other cancers. Both male and female family members of carriers are highly encouraged to talk with their physicians about genetic counseling and their own cancer risk and recourse.
A new kind of treatment for cancer
Precision medicine is an emerging strategy in cancer care in which personalized treatments are chosen based on characteristics of a patient’s tumor. An example is a class of precision medicines called PARP inhibitors, used to treat breast and ovarian cancers with mutations in BRCA1/2.
Clinical trials conducted by PCF-funded researchers demonstrated that these treatments can also be effective against prostate cancer with mutations in BRCA2. The pharmaceutical industry rapidly followed on these findings with larger trials. Now, two PARP inhibitors are under FDA review for the treatment of advanced prostate cancer with BRCA2mutations.