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
Regardless of cancer type, people with a BRCA mutation may qualify for clinical trials looking for more effective treatments for 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: Based on results from a large clinical trial, experts recommend one year of the PARP inhibitor olaparib for people with early-stage, HER2-negative breast cancer who have an inherited BRCA mutation and who are at high risk for recurrence.
- 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 an inherited 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)
- 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 modular, phase I/ phase 1 b, open-label, multicentre study of ceralasertib administered orally in combination with cytotoxic chemotherapy regimens and/or novel anti-cancer agents, to patients with advanced malignancies.
- NCT03428802: Pembrolizumab in Treating Participants With Metastatic, Recurrent or Locally Advanced Cancer and Genomic Instability. This phase II trial studies how well pembrolizumab works in treating participants with cancer that has spread to other places in the body, has come back or has spread to nearby tissues or lymph nodes. The study is specifically enrolling people with inherited or tumor mutations in BRCA1 or BRCA2.
- NCT02286687: Talazoparib in Treating Patients With Recurrent, Refractory, Advanced, or Metastatic Cancers and Alterations in the BRCA 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 the breast cancer, early onset (BRCA) genes.
- NCT03641755: Olaparib + Sapacitabine to Treat Metastatic Breast Cancer in People with a BRCA1 or BRCA2 Mutation. This research study is studying a combination of drugs as a possible treatment for metastatic breast cancer in people with a BRCA mutation.
- NCT03964532: TALAVE: A Pilot Trial of Induction Talazoparib Followed by Combination of Talazoparib and Avelumab in Advanced Breast Cancer. TALAVE is a study for patients who have advanced or metastatic breast cancer to look at whether giving talazoparib alone followed by talazoparib with avelumab is a safe and effective treatment.
- 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).
- NCT02849496: Olaparib with or without Atezolizumab in Treating Patients with Locally Advanced Unresectable or Metastatic Non-HER2-Positive Breast Cancer. The goal of this study is to look at whether giving olaparib (Lynparza) in combination with the immunotherapy atezolizumab (Tecentriq) improves outcomes for patients compared to olaparib alone.
- NCT03685331: HOPE: Olaparib, Palbociclib and Fulvestrant in Patients With BRCA Mutation-associated, HR+, HER2-metastatic Breast Cancer. The goal of this study is to find the best dose and measure side effects of palbociclib when given together with olaparib and fulvestrant, in treating people with hormone receptor-positive (HR+), HER2-negative metastatic breast cancer who have a BRCA1 or BRCA2 mutation.
- NCT04633239: Testing the Addition of Abemaciclib to Olaparib for Women With Recurrent Ovarian Cancer. This trial identifies the side effects and best dose of abemaciclib when given together with olaparib in treating patients with ovarian cancer that responds at first to treatment with drugs that contain the metal platinum but then comes back within a certain period (recurrent platinum-resistant).
- NCT03586661: Niraparib and Copanlisib in Treating Patients With Recurrent Endometrial, Ovarian, Primary Peritoneal, or Fallopian Tube Cancer. This trial studies the best dose and side effects of niraparib and copanlisib in treating patients with endometrial, ovarian, primary peritoneal, or fallopian tube cancer that has come back. Open to people who progress after PARP inhibitors.
- NCT04377087: Delayed Initiation of Olaparib Maintenance Therapy in Platinum Sensitive Recurrent Ovarian Cancer. This study will test if delaying the start of the olaparib until there is a rise in a tumor marker called CA-125 will result in a longer time until the next or different treatment for the patient's cancer. The study will look at how delaying the start of maintenance therapy affects symptoms, physical function, quality of life; and financial impact.
- NCT04374630: Study With Afuresertib and Paclitaxel in Platinum Resistant Ovarian (PROFECTA-II). Afuresertib is an AKT inhibitor, a new class of agents under development that may provide treat platinum resistant ovarian cancer (PROC) progression. Afuresertib plus chemotherapy has demonstrated anti-tumor efficacy and an acceptable safety profile in patients with PROC in a published Phase I/II study.
- NCT04030559: Niraparib Before Surgery in Treating Patients With High Risk Localized Prostate Cancer and DNA Damage Response Defects. This trial studies how well niraparib 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.
- 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.
- 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.
- NCT04858334: Olaparib or Placebo in Patients with Surgically Removed Pancreatic Cancer who have a BRCA1, BRCA2 or PALB2 Mutation (APOLLO). The purpose of APOLLO is to compare the usual approach (observation) to treatment for one year with a drug called olaparib, in patients with a BRCA1, BRCA2 or PALB2 mutation and resectable pancreatic cancer.
- 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.
- NCT04493060: Niraparib and Dostarlimab for the Treatment of Germline or Somatic BRCA1/2 and PALB2 Mutated Metastatic Pancreatic Cancer. This study looks at how well the PARP inhibitor niraparib and the immunotherapy drug dostarlimab work together in treating patients with metastatic pancreatic cancer, who also have an inherited or tumor mutation in one of the following genes: BRCA1, BRCA2, PALB2, BARD1, RAD51c, RAD51d.
Visit our Research Search and Enroll Tool to find additional cancer treatment studies.