In JAMA this week, an international team of researchers reports a study of the associations between mutations in the BRCA1 and BRCA2 genes, and survival rates of women with invasive epithelial ovarian cancer. The team analyzed data from 26 observational studies of women with ovarian cancer, including 1,213 cases of epithelial ovarian cancer with germline mutations in BRCA1 or BRCA2. They found that epithelial ovarian cancer patients with BRCA1 mutations had a five-year survival rate of 44 percent, women with BRCA2 mutations had a five-year survival rate of 52 percent, and non-carriers had a five-year survival rate of 36 percent. "After adjusting for study and year of diagnosis, BRCA1 and BRCA2 mutation carriers showed a more favorable survival than noncarriers," the authors write. "These survival differences remained after additional adjustment for stage, grade, histology, and age at diagnosis."
In a related editorial in JAMA this week, Memorial Sloan-Kettering Cancer Center's David Spriggs and Weill Cornell Medical College's David Hyman explore the implications of BRCA mutations in ovarian cancer. This newest study shows that it's important to stratify ovarian cancer patients based on the BRCA mutation status, the authors write. In addition, the study shows that the current approach for developing targeted treatments for ovarian cancer needs to be rethought. "The findings of Bolton et al. are the latest evidence that ovarian cancer is a much more genetically and biologically heterogeneous disease than previously appreciated," Spriggs and Hyman write. "Further studies in similarly large data sets are needed to better understand the effects of somatic and epigenetic alterations in BRCA gene function as well as complex interactions with other inherited alleles."