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FDA approves expanded use of AstraZeneca cancer drug

12 January 2018

Young women diagnosed with breast cancer who carry a BRCA mutation have the same chances of survival as women without the mutation after undergoing treatment.

"Breast cancer is the most frequent cancer in women (12% lifetime risk) and hormonal contraception the most frequent medical exposure in women (40% of all women of reproductive age in Denmark)".

Faulty BRCA1 or BRCA2 genes are inherited and these mutations place women at a greater risk of breast and some ovarian cancers.

The risk for breast cancer with hormonal contraceptive use is not a new concept - the prescribing information for oral contraceptives, for example, cautions that there is a potential for breast cancer development.

The findings might come as a welcomed breath of fresh air for many young women newly diagnosed with breast cancer, particularly those who are BRCA carriers.

In 2013, Hollywood star Angelina Jolie announced she had had both breasts surgically removed as a preventative measure after tests revealed she carried the mutation, despite not having been diagnosed with cancer.

This UK study findings suggest mastectomies and other invasive preventive surgery may not be necessary soon after diagnosis, as has been the norm. Olaparib was first approved in 2014 for ovarian cancer and has now received approval to treat patients with germline BRCA-mutated, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer who were previously administered chemotherapy, according to the FDA.

Actually, those with a BRCA mutation had slightly higher survival rates for the first two years after diagnosis, in the case of patients with triple-negative breast cancer. The drug was linked with tumor shrinkage in 60% of the patients with germline BRCA1 or BRCA2 mutations taking the drug, compared to 29% in the chemo group.

The study recruited young women with breast cancer between the years 2000 and 2008, when BRCA testing and risk-reducing surgery were not routine for early breast cancer (stage one or stage two).

"Our data provides some reassurance that patients who are diagnosed with a BRCA gene fault as part of their cancer treatment journey can complete and recover from their breast cancer treatment, which is important", she said.

Most of the women lived 10 years; 73 percent of the women with BRCA mutations lived 10 years and 70 percent of women without the mutations did.

"Decisions about timing of additional surgery aimed at reducing future second primary-cancer risks should take into account patient prognosis associated with the first malignancy and patient preferences", the authors write. There was no significant difference in survival at 5 or 10 years.

These findings were consistent regardless of whether mutations were in the BRCA1 or BRCA2 gene, the researchers report.

FDA approves expanded use of AstraZeneca cancer drug