BRCA1: Options for Cancer Treatment

Cancer Treatment for People with Inherited BRCA1 Mutations

Testing positive for an inherited BRCA1 mutation may affect your treatment options or eligibility for clinical trials studying which treatments work best. BRCA1 mutations may effect treatment options for the following cancers.

Breast 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. 

Unlike women, the risk for a second breast cancer diagnosis in men with a BRCA1 mutation is low. For this reason, bilateral mastectomy may not be recommended. 

Treatment options 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 options for early-stage, high-risk breast cancer

The PARP inhibitor, Lynparza is FDA approved to treat people with early-stage, HER2-negative breast cancer who have an inherited BRCA mutation and who are at high risk for recurrence.

Ovarian, fallopian tube or primary peritoneal cancer

Maintenance therapy

Maintenance therapy is a type of treatment that is given after chemotherapy treatment has been completed to keep the cancer from returning. There are three oral PARP inhibitors with FDA approval for maintenance therapy in advanced ovarian, fallopian tube and primary peritoneal cancer; Lynparza, Rubraca (rucaparib) and Zejula (niraparib). 

• People with a BRCA mutation who have completed front-line (their first course) of chemotherapy for ovarian cancer may use Lynparza as maintenance therapy to delay recurrence.
• Lynparza in combination with Avastin (bevacizumab) may be used as maintenance therapy after front-line platinum chemotherapy in people with a BRCA mutation.
• Lynparza, Rubraca, and Zejula may each be used as maintenance therapy to treat recurrent ovarian cancer in people 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 this setting regardless of BRCA mutation status. However, research suggests that the drugs work particularly well for people with a BRCA mutation.

Pancreatic cancer

Choice of chemotherapy 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 often used to treat pancreatic cancer. 

Maintenance therapy after chemotherapy for advanced pancreatic cancer

The oral PARP inhibitor, Lynparza may be used as maintenance therapy for people with a BRCA mutation who completed platinum-based chemotherapy and whose pancreatic cancer has not come back or gotten worse.

Participate in Pancreatic Cancer Treatment Research

Below are some of our featured research studies looking at new treatments for pancreatic cancer. To search for more studies, visit our Search and Enroll Tool. 

Prostate cancer

Prostate cancers tend to be slow-growing in most people, but prostate cancers in people with a BRCA mutation may be aggressive.

Several PARP inhibitors have received FDA approval for treating metastatic, castraction-resistant prostate cancer (mCRPC) in people with BRCA mutations. 

• Akeega is a drug that combines the hormone therapy drug abiraterone with the PARP inhibitor niraparib in a single tablet. Akeega may be used in combination with prednisone as a treatment for metastatic castration-resistant prostate cancer (mCRPC) for people with a BRCA1 or BRCA2 mutation.
• Lynparza may be used to treat MCRPC in people who have a mutation in BRCA1 or another gene linked to DNA damage repair whose prostate cancer got worse or came back after receiving hormone therapy with enzalutamide (Xtandi) or abiraterone (Zytiga).
• Rubraca may be used to treat metastatic castration-resistant prostate cancer in people who have already received treatment with a certain type of hormone therapy and chemotherapy.
• Talzenna (talazoparib) may be used to treat people with metastatic, castration-resistant prostate cancer who have a mutation in BRCA1 or another gene linked to a certain type of DNA damage repair. 

Participate in Prostate Cancer Treatment Research

Below are some of our featured research studies looking at new treatments for prostate cancer. To search for more studies, visit our Search and Enroll Tool. 

Advanced cancers with no treatment options

If you have a BRCA1 mutation and advanced cancer that no longer responds to standard therapy, you may have additional options. Talk with your doctor about tumor testing to learn whether you might benefit from a PARP inhibitor, another targeted therapy or participation in a clinical trial.