ATM: Options for Cancer Treatment

Cancer Treatment for People with Inherited ATM Mutations

Testing positive for an inherited ATM mutation may affect your treatment options or eligibility for clinical trials studying which treatments work best. The following are examples of situations where an ATM mutation may play a part in treatment decision-making. 

Radiation therapy in people with a mutation in both copies of their ATM gene 

People with an inherited mutation in both copies of the ATM gene (people with Ataxia-Telangiectasia) are very sensitive to radiation damage. However, according to experts, people with a single ATM mutation can safely undergo radiation therapy to treat their cancer as recommended by their oncologist. 

Breast cancer surgical decisions 

It is believed that the risk for a second breast cancer diagnosis in women with an ATM mutation is slightly higher than women without a mutation. For this reason, some women with ATM mutations who are diagnosed with breast cancer may choose  bilateral mastectomy rather than lumpectomy and radiation. Mutation carriers who undergo mastectomy are less likely to develop a second breast cancer. These decisions should be made after discussion of the benefits and risks of each option with your healthcare providers.

Targeted therapies for advanced cancers

PARP inhibitors are a type of targeted therapy that work by blocking a protein used to repair DNA damage. People with an ATM mutation who have been diagnosed with cancer may want to ask their doctor about whether they might benefit from PARP inhibitor therapy or a PARP inhibitor research study. 

PARP inhibitors for metastatic prostate cancer

The PARP inhibitors, Lynparza (olaparib) and Talzenna (talazoparib) have received FDA-approval to treat metastatic, castration-resistant prostate cancer (mCRPC), with a mutation in ATM or another gene linked to a certain type of DNA damage repair. 

PARP inhibitors for advanced ovarian, fallopian tube or primary peritoneal cancer

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 ("homologous recombination deficiency") can help identify which ovarian cancers may respond to treatment with a PARP inhibitor.

Maintenance therapy after first-line treatment

• HRD testing can help people 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 (niraparib) is approved for maintenance therapy in people 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 people 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. 

To learn more about treatment options for specific types of cancer, visit our section on cancer treatment by cancer type. 

PARP inhibitors or other targeted therapies for advanced cancers with no other treatment options

If you have an ATM mutation and another type of advanced cancer that no longer responds to standard therapy, you may want to talk with your doctor about whether you might benefit from treatment with a PARP inhibitor or participation in a clinical trial. 

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