BRCA2 Mutations Tied With Poor Survival, Progression in mCRPC
Researchers find BRCA2 mutations are associated with worse outcomes among men with mCRPC.
The presence of a BRCA2 mutation was associated with shorter cause-specific survival (CSS) among men with metastatic castration-resistant prostate cancer (mCRPC), according to a late-breaking abstract of an observational study presented at the European Society of Medical Oncology (ESMO) 2017 Congress in Spain.
Poor outcomes with prostate cancer, including progression to metastasis, has been associated with mutations in DNA repair genes. The effect of these mutations on mCRPC outcomes, however, has not been established. The purpose of this study was to determine if mutations in DNA repair genes affect survival among men with mCRPC.
The multicenter, prospective, observational study enrolled 419 men with newly diagnosed mCRPC with unknown mutation status of DNA repair genes who were treated with physician's choice among standard mCRPC therapies.
Gene analysis found mutations in BRCA1 among 4 patients, BRCA2 among 14 patients, and in ATM among 8 patients. There was no difference in time from androgen-deprivation therapy initiation to progression to mCRPC, performance status, median prostate-specific antigen level, and location of metastases among patients with or without mutations.
CSS was similar between groups, with a median of 28.5 months and 36.0 months among patients with or without mutations, respectively (P = .5). The median CSS was also similar between groups from first taxane therapy.
Men with a BRCA2 mutation, however, were more likely to have a shorter CSS at 17.4 months compared with those without a mutation (P = .02). The median CSS from first taxane was 12.8 months in the group with a BRCA2 mutation compared with 24.5 months in the group without mutations (P < .01).
Progression-free survival was similar between groups, including the BRCA2-mutated subgroup.
According to the authors, these data suggest that BRCA2 mutations are associated with worse outcomes among men with mCRPC.
- Castro Marcos E, Romero Laorden N, Piulats Rodriguez J, et al. PROREPAIR-B: a prospective cohort study of DNA repair defects in metastatic castration resistant prostate cancer (mCRPC). Presented at: European Society of Medical Oncology (ESMO) 2017 Congress; Madrid, Spain: September 8-12, 2017. Abstract LBA32.