Cancer treatment for people with inherited ATM mutations
People with an inherited ATM mutation who have been diagnosed with cancer may have different treatment options than people without a mutation. You may also consider enrolling in a clinical trial studying which treatments work best for people with an inherited ATM mutation. To learn more about standard of care treatment options for specific types of cancer, visit our section on Cancer Treatment by Cancer Type.
If you have an inherited ATM mutation, have been diagnosed with cancer and any of the situations below apply to you, you may want to speak to your doctor about your medical options.
- You have metastatic prostate cancer
- You have advanced ovarian cancer
- You are making breast cancer surgical decisions
- You have cancer and need radiation therapy
Regardless of diagnosis and situation, people with an ATM mutation may qualify for clinical trials looking for more effective treatments for cancer.
PARP inhibitors are a type of targeted therapy that work by blocking a protein used to repair damaged DNA. They were initially developed to treat cancers in people with an inherited BRCA1 or BRCA2 mutation. Since then, research and additional FDA approvals have expanded use of PARP inhibitors to more situations. People with an ATM mutation who have been diagnosed with cancer may want to ask their doctor about PARP inhibitor therapy.
The PARP inhibitor, Lynparza (olaparib) has received FDA-approval to treat men with metastatic, castration-resistant prostate cancer, who have a mutation in ATM or another gene linked to a certain type of DNA damage repair. Lynparza has been approved to treat men whose prostate cancer has progressed on enzalutamide (Xtandi) or abiraterone (Zytiga).
Several PARP inhibitors have been approved to treat ovarian cancers at different stages of the disease. In some situations, a tumor biomarker test known as an HRD test ("hemologous recombination deficiency") can help women with advanced ovarian cancer learn if they may benefit from a PARP inhibitor.
- Advanced cancer which has recurred after third-line treatment:
- HRD testing can help women with advanced ovarian cancer which has recurred after three lines of treatment learn if they may benefit from the PARP inhibitor Zejula (niraparib).
- Maintenance therapy after first-line treatment
- HRD testing can help women with advanced ovarian cancer learn if they may benefit from the PARP inhibitor Lynparza (olaparib) in combination with Avastin (bevacizumab) as maintenance therapy after first-line platinum chemotherapy.
- Zejula is approved for maintenance therapy in women with advanced ovarian, fallopian tube, or primary peritoneal cancer who had a complete or partial response to first-line platinum-based chemotherapy. Zejula for maintenance therapy does not require an HRD test.
- Maintenance therapy after treatment of recurrent cancer
- Zejula, Rubraca (rucaparib) and Lynparza are all approved for maintenance therapy in women with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum based chemotherapy. In this setting, none of these drugs requires an HRD test.
Because of the high risk for a second breast cancer diagnosis, women who are diagnosed with breast cancer who test positive for an inherited mutation in ATM may choose bilateral mastectomy rather than lumpectomy and radiation. Mutation carriers who undergo mastectomy are less likely to develop a second breast cancer.
Based on research in people who have a mutation in both copies of their ATM gene (see our Other Considerations section), there have been some questions raised about the safety of radiation therapy to treat cancer in people with a single ATM mutation. According to experts, cancer patients with a single ATM mutation can undergo radiation therapy to treat their cancer as recommended by their oncologist.
If you are a person with an ATM mutation, you can find peer support through the following resources:
- FORCE blog: Read stories submitted by people with ATM mutations
- Video: FORCE members from the ATM community
- FORCE's Peer Navigation Program will match you with a volunteer who shares your mutation and situation and provide you with a free resource guide.
- Register for the FORCE Message Boards to connect with others who share your situation. Once you register, you can post on the Share Your Mutation board to connect with other people who carry an ATM mutation and the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Contact the FORCE impact leaders in your area to link to local support groups and other resources.
- Attend a virtual support meeting in your area.
The following cancer treatment studies are open to people with an ATM mutation.
Advanced solid tumors of any type
- NCT04171700: A Study to Evaluate Rucaparib in Patients With Solid Tumors and With Deleterious Mutations in HRR Genes (LODESTAR). This study is evaluating the response of rucaparib in patients with various solid tumors and with deleterious mutations in Homologous Recombination Repair (HRR) genes.
- NCT02264678: Ascending Doses of Ceralasertib in Combination With Chemotherapy and/or Novel Anti Cancer Agents. This is a study of ceralasertib administered orally in combination with chemotherapy regimens and/or novel anti-cancer agents, to patients with advanced cancer.
- NCT02286687: Talazoparib in Treating Patients With Recurrent, Refractory, Advanced, or Metastatic Cancers and Alterations in DNA Damage Repair Genes. This phase II trial studies how well talazoparib works in treating patients with cancers that have returned after a period of improvement, do not respond to treatment, or have spread to other parts of the body, and have alterations in certain genes.
- NCT03344965: A Phase 2 Study of Olaparib Monotherapy in Metastatic Breast Cancer Patients with Germline or Somatic Mutations in DNA Repair Genes (Olaparib Expanded). Olaparib (Lynparza) is a type of treatment known as a PARP inhibitor, which is approved for metastatic breast cancer in people with a BRCA mutation. This study is looking at how well olaparib works in people with an ATM or other mutation.
- NCT02401347: Talazoparib Beyond BRCA (TBB) Trial. People with an ATM mutation who have metastatic triple-negative breast cancer may qualify for this study. Talazoparib (Talzenna) is a type of treatment known as a PARP inhibitor, which is approved for metastatic breast cancer in people with a BRCA mutation. This study is looking at how well talazoparib works in people with an ATM or other mutation.
- NCT03404960: Niraparib + Ipilimumab or Nivolumab in Progression Free Pancreatic Adenocarcinoma After Platinum-Based Chemotherapy (Parpvax). This study will look at the effectiveness, safety, and anti-tumor activity (preventing growth of the tumor) of the drugs Niraparib with either Ipilimumab or Nivolumab on patients and their pancreatic cancer.
- NCT04666740: Pembrolizumab and Olaparib for Metastatic Pancreatic Cancer with Homologous Recombination Deficiency or Exceptional Response to Platinum Chemotherapy. The goal of this study is to look at whether combining the immunotherapy drug, pembrolizumab and the PARP inhibitor, olaparib is a more effective treatment for this cancer than taking olaparib alone. This study is specifically enrolling people with inherited or acquired ATM mutations.
- NCT02975934: A Study of Rucaparib Verses Physician's Choice of Therapy in Patients With Metastatic Castration-resistant Prostate Cancer and Homologous Recombination Gene Deficiency (TRITON3). TRITON3 study is looking at how well the PARP inhibitor rucaparib (Rubraca) works for men with a BRCA or ATM mutation and advanced prostate cancer.
- NCT03012321: Abiraterone/Prednisone, Olaparib, or Abiraterone/Prednisone + Olaparib in Patients With Metastatic Castration-Resistant Prostate Cancer With DNA Repair Defects. This is a phase II study in men with metastatic castration resistant prostate cancer (mCRPC) open to men with an ATM or other mutation.
- NCT03442556: Docetaxel, Carboplatin, and Rucaparib Camsylate in Treating Patients With Metastatic Castration Resistant Prostate Cancer With Homologous Recombination DNA Repair Deficiency. This trial studies how well docetaxel with carboplatin followed by rucaparib camsylate works in treating patients with metastatic castration resistant prostate cancer. The study is open to men with an ATM or other inherited mutation.
- NCT04030559: Niraparib Before Surgery in Treating Patients With High Risk Localized Prostate Cancer and DNA Damage Response Defects. This trial studies how well niraparib, when given before surgery, works in treating patients with high risk prostate cancer that has not spread to other parts of the body.
- NCT03395197: Talazoparib + Enzalutamide vs. Enzalutamide Monotherapy in mCRPC (TALAPRO-2). This study compares progression-free survival in men with mCRPC treated with talazoparib plus enzalutamide vs. enzalutamide after confirmation of the starting dose of talazoparib in combination with enzalutamide.
Visit our Research Search and Enroll Tool to find additional cancer treatment studies.