Cancer treatment for people with inherited BRCA1 mutations
People with an inherited BRCA1 mutation who have been diagnosed with cancer may have different treatment options than people who do not have an inherited mutation. For example, PARP inhibitors are a type of targeted therapy used to treat cancers in people with certain mutations, including BRCA1. 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 BRCA1 mutation, have been diagnosed with cancer and any of the situations below apply, you may want to speak to your doctor about your medical options. You may also consider enrolling in a clinical trial studying which treatments work best for people with an inherited BRCA1 mutation.
- You have breast cancer
- You have advanced ovarian, fallopian tube or primary peritoneal cancer
- You have pancreatic cancer
- You have prostate cancer
- Surgical decisions: Because of the very high risk for a second (or third) breast cancer diagnosis, women who are diagnosed with breast cancer who test positive for an inherited mutation in BRCA1 often choose bilateral mastectomy rather than lumpectomy and radiation. Mutation carriers who undergo mastectomy are less likely to develop a second breast cancer.
- Treatment for metastatic breast cancer: The PARP inhibitors, Lynparza (also known as olaparib) and Talzenna (also known as talazoparib) both have received FDA approval for treating metastatic breast cancer caused by a BRCA mutation.
- Treatment for early-stage breast cancer: Although not yet FDA approved for early stage breast cancer, PARP inhibitors are being studied in this setting to learn if they improve outcomes.
- Other considerations: Women with an inherited BRCA1 mutation are more likely to be diagnosed with a type of breast cancer known as triple-negative breast cancer. Women with an inherited BRCA1 mutation and early stage breast cancer appear to have similar prognosis and outcomes as women with a similar diagnosis who do not have a mutation.
Research has shown that women an inherited BRCA1 mutation and ovarian cancer appear to have better prognosis and outcomes than women with a similar diagnosis who do not have a mutation.
There are three PARP inhibitors with FDA approval for treating advanced ovarian, fallopian tube and primary peritoneal cancer. Lynparza (olaparib), Rubraca (rucaparib) and Zejula (niraparib).
- Advanced recurrent ovarian cancer: All three PARP inhibitors have FDA approval for treating advanced recurrent ovarian, fallopian tube and primary peritoneal cancer in women with a BRCA mutation, although the approvals differ slightly.
- Rubraca is approved for women who have received two or more prior lines of treatment, and have an inherited BRCA mutation or an acquired BRCA mutation found by testing their tumor.
- Lynparza is approved for women who have received three or more prior lines of treatment, and have an inherited BRCA mutation or an acquired BRCA mutation found by testing their tumor.
- Zejula is approved for women who have received three or more prior lines of treatment, and have an inherited BRCA mutation or a type of biomarker found by a test known as HRD.
- Maintenance therapy: Maintenance therapy is a type of treatment that is given after chemotherapy treatment has been completed to try to keep the cancer from returning. The goal of maintenance therapy is to extend the length of time before a new recurrence emerges or even to turn a temporary remission into a long-term cure. All three PARP inhibitors have all been approved by the FDA for treating ovarian, primary peritoneal and fallopian tube cancer in the maintenance setting.
- Lynparza has been approved for front-line maintenance therapy in women with advanced ovarian cancer caused by BRCA mutation. This means that women with a BRCA mutation who have completed their first course of chemotherapy for ovarian cancer may use Lynparza as maintenance therapy to delay recurrence.
- Lynparza in combination with bevacizumab has been approved as maintenance therapy after front-line platinum chemotherapy in women with a BRCA mutation.
- Lynparza, Rubraca, and Zejula have all received FDA approval as maintenance therapy for women with recurrent ovarian cancer, who had either a complete or partial response to the most recent line of recurrence therapy. These PARP inhibitors have been approved for maintenance therapy in women with, and women without a BRCA mutation. However, research suggests that the agents work particularly well in women with a BRCA mutation.
- Treatment for advanced pancreatic cancer: People with pancreatic cancer and an inherited BRCA mutation may respond better to treatment that includes a type of chemotherapy known as platinum. Oxaliplatin is a platinum-containing drug used in some pancreatic cancer regimens.
- Maintenance therapy: Lynparza is a PARP inhibitor which is FDA approved for maintenance treatment of pancreatic cancer in people with a BRCA mutation whose disease has not progressed after completing first-line platinum-based chemotherapy.
Prostate cancers tend to be slow-growing in most men, but prostate cancers in men with a BRCA mutation may be more aggressive than in men without a mutation. Two PARP inhibitors have received FDA approval for treating advanced prostate cancer in men with BRCA mutations.
- Lynparza may be used to treat men with metastatic, castration-resistent prostate cancer, who have a mutation in BRCA or another gene linked to DNA damage repair. Lynparza may be used to treat men whose prostate cancer has progressed on enzalutamide (Xtandi) or abiraterone (Zytiga).
Rubraca may be used to treat men with a BRCA mutation who have metastatic castration-resistant prostate cancer and who have been treated with androgen receptor-directed therapy and a taxane-based chemotherapy.
If you are a person with a BRCA1 mutation, you can find peer support through the following resources:
- FORCE blog: Read stories submitted by people with BRCA1 mutations
- Video: FORCE members with a BRCA1 mutation
- 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 a BRCA1 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 a BRCA1 mutation.
Advanced solid tumors (including breast, ovarian, pancreatic, prostate or others)
- NCT03565991: A Phase II Study to Evaluate the Safety and Anti-tumor Activity of Avelumab in Combination with Talazoparib in Patients with a BRCA or ATM Mutation. This study is looking at the safety and effectiveness of the combination of an immunotherapy (known as Avelumab) and a PARP inhibitor (known as Talazoparib) is for treating patients with locally advanced or metastatic solid tumors who have an inherited mutation in ATM, BRCA1 or BRCA2.
- NCT03718091: M6620 (VX-970) in Selected Solid Tumors. This is a phase 2 study looking at M6620, a drug designed to inhibit the ATR enzyme. Inhibiting ATR may block how cancers repair their damaged DNA. The study is specifically enrolling patients with a BRCA1 or other mutation.
- 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.
- NCT03330847: Safety and Efficacy of Olaparib Combined with Agents Targeting DNA Damage Repair Compared to Olaparib Alone. The purpose of this study is to assess the efficacy and safety of treatment with the PARP inhibitor, olaparib combined with the drug Ceralasertib compared with olaparib alone for patients with Triple-Negative Breast Cancer.
- NCT03911973: Gedatolisib Plus Talazoparib in Advanced Triple Negative or BRCA1/2 Positive, HER2 Negative Breast Cancers. This study is designed to determine efficacy of gedatolisib in combination with talazoparib in advanced HER2 negative breast cancer that is triple negative or BRCA1/2 positive (deficient).
- 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 a BRCA or other mutation.
- NCT02734004: A Phase I/II Study of MEDI4736 in Combination With Olaparib in Patients With Advanced Solid Tumors. (MEDIOLA). The purpose of this study is to look at the effectiveness, safety, and antitumor activity of study drugs MEDI4736 in combination with olaparib and MEDI4736 in combination with olaparib and bevacizumab in advanced breast cancer patients with a BRCA1 or other mutation.
- NCT02203513: A Phase II Single Arm Pilot Study of the Chk1/2 Inhibitor (LY2606368) in BRCA1/2 Mutation Associated Breast or Ovarian Cancer, Triple Negative Breast Cancer, High Grade Serous Ovarian Cancer, and Metastatic Castrate-Resistant Prostate Cancer. The goal of this study is to see if LY2606368 helps shrink tumors in patients with certain breast, ovarian or prostate cancers.
- NCT02855944: ARIEL4: A Study of Rucaparib Versus Chemotherapy BRCA Mutant Ovarian, Fallopian Tube, or Primary Peritoneal Cancer Patients. ARIEL4 is a treatment study for women with relapsed, high-grade epithelial ovarian, fallopian tube, or primary peritoneal cancer who have a BRCA1 or BRCA2 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.
- 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 a BRCA1 or other inherited mutation.
- NCT03338790: A Phase 2 Study of Nivolumab in Combination with Either Rucaparib, Docetaxel, or Enzalutamide in Men with Castration-resistant Metastatic Prostate Cancer (CheckMate-9KD). The purpose of this study is to compare three different combination therapies, each containing a drug called nivolumab and another anti-cancer drug in men metastatic prostate cancer.
- 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 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 a BRCA1 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.
Visit our Research Search and Enroll Tool to find additional cancer treatment studies.