Optimal tactics of ovarian and metachronous breast cancer treatment in BRCA mutations carriers
https://doi.org/10.17650/2782-3202-2023-3-4-28-34
Abstract
Treatment of patients with multiple primary malignant neoplasms caused by genetic mutations requires correct priorities from the clinician in selection of the most effective therapeutic tactics. An important aspect in this case is the identification of the neoplasm determining patient’s survival. The main goal is to achieve maximal treatment effect for this tumor and use therapy methods for control of other synchronous and metachronous tumors.
The article presents a clinical case of a patient with BRCA1 mutation-associated recurrent ovarian cancer and de novo breast cancer of negative subtype. Combination multidisciplinary and personalized approach to treatment which led to the maximally effective result is described. Personalized approach to prescription of antitumor drug therapy, timing of surgical intervention and subsequent targeted therapy allowed to realize maximal antitumor effect and increase the patient’s lifespan.
About the Authors
N. M. KutakovRussian Federation
Nikita Mikhailovich Kutakov
111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
E. K. Ibragimov
Russian Federation
111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
D. A. Chekini
Russian Federation
111 1st Uspenskoe Shosse, Lapino, Moscow region 143081
References
1. Couch F.J., Nathanson K.L., Offit K. Two decades after BRCA: setting paradigms in personalized cancer care and prevention. Science 2014;343(6178):1466–70. DOI: 10.1126/science.1251827
2. Antoniou A., Pharoah P.D., Narod S. et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet 2003;72(5):1117–30. DOI: 10.1086/375033
3. Chen S., Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol 2007;25(11):1329–33. DOI: 10.1200/JCO.2006.09.1066
4. Kuchenbaecker K.B., Hopper J.L., Barnes D.R. et al. Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers. JAMA 2017;317(23):2402–16. DOI: 10.1001/jama.2017.7112
5. Tyulyandina A.S., Kolomiets L.A., Morkhov K.Yu. et al. Practical recommendations for the drug treatment of ovarian cancer, primary peritoneal cancer and fallopian tube cancer. Zlokachestvenniye opukholy. Prakticheskiye rekomendatsii RUSSCO = Malignant tumors. Practical recommendations of RUSSCO 2022;12(3s2):198–211. (In Russ.). DOI: 10.18027/2224-5057-2022-12-3s2-198-211
6. Tyulyandin S.A., Artamonova E.V., Zhukova L.G. et al. Practical recommendations for the drug treatment of breast cancer. Zlokachestvenniye opukholy. Prakticheskiye rekomendatsii RUSSCO = Malignant tumors. Practical recommendations of RUSSCO 2022;12(3s2): 155–97. (In Russ.). DOI: 10.18027/2224-5057-2022-12-3s2-155-197
7. Bedrosian I., Hu C.Y., Chang G.J. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients. J Natl Cancer Inst 2010;102(6):401–9. DOI: 10.1093/jnci/djq018
8. Lostumbo L., Carbine N.E., Wallace J. Prophylactic mastectomy for the prevention of breast cancer. Cochrane Database Syst Rev 2010;(11):CD002748. DOI: 10.1002/14651858.CD002748.pub3
9. Domchek S.M., Friebel T.M., Singer C.F. et al. Association of risk-reducing surgery in BRCA1 or BRCA2 mutation carriers with cancer risk and mortality. JAMA 2010;304(9):967–75. DOI: 10.1001/jama.2010.1237
10. Rebbeck T.R., Lynch H.T., Neuhausen S.L. et al. Prophylactic oophorectomy in carriers of BRCA1 or BRCA2 mutations. N Engl J Med 2002;346(21):1616–22. DOI: 10.1056/NEJMoa012158
11. Kauff N.D., Satagopan J.M., Robson M.E. Risk-reducing salpingo-ophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med 2002;346(21):1609–15. DOI: 10.1056/NEJMoa020119
12. Pujade-Lauraine E., Ledermann J.A., Selle F. et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2017;18(9):1274–84. DOI: 10.1016/S1470-2045(17)30469-2
13. Mirza M.R., Monk B.J., Herrstedt J. et al. Niraparib maintenance therapy in platinum-sensitive, recurrent ovarian cancer. N Engl J Med 2016;375(22):2154–64. DOI: 10.1056/NEJMoa1611310
14. Coleman R.L., Oza A.M., Lorusso D. et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2017;390(10106):1949–61. DOI: 10.1016/S0140-6736(17)32440–6
15. Tasca G., Dieci M.V., Baretta Z. et al. Synchronous and metachronous breast and ovarian cancer: experience from two large cancer center. Front Oncol 2020;10:608783. DOI: 10.3389/fonc.2020.608783
Review
For citations:
Kutakov N.M., Ibragimov E.K., Chekini D.A. Optimal tactics of ovarian and metachronous breast cancer treatment in BRCA mutations carriers. MD-Onco. 2023;3(4):28-34. (In Russ.) https://doi.org/10.17650/2782-3202-2023-3-4-28-34