Cancer Treatment for People with Inherited Mutations
Testing positive for an inherited mutation may affect your treatment options or eligibility for clinical trials studying which treatments work best. The following are examples of situations where a mutation may play a part in treatment decision-making. Note that when we use "men" and "women" we are referring to the sex you were assigned at birth.
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 in often choose mastectomy rather than 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 mutation is low. For this reason, mastectomy may not be recommended.
Treatment options for breast cancer
The PARP inhibitors, Lynparza (also known as ) and (also known as ) both have received approval for treating breast cancer caused by a mutation.
Treatment options for , high-risk breast cancer
The , Lynparza is approved to treat people with , breast cancer who have an inherited mutation and who are at high risk for recurrence.
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 approval for in advanced ovarian, and primary peritoneal cancer, Lynparza, () and ().
- People with a mutation who have completed front-line (their first course) of chemotherapy for ovarian cancer may use Lynparza as to delay recurrence.
- Lynparza in combination with Avastin (bevacizumab) may be used as after front-line platinum chemotherapy in people with a mutation.
- Lynparza, , and 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 in this setting regardless of mutation status. However, research suggests that the drugs work particularly well for people with a mutation.
Choice of chemotherapy for advanced pancreatic cancer
People with pancreatic cancer and an inherited 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.
Maintenancy therapy after chemotherapy for advanced pancreatic cancer
The oral , Lynparza may be used as for people with a mutation who completed platinum-based chemotherapy and whose pancreatic cancer has not come back or gotten worse.
cancers tend to be slow-growing in most people, but cancers in people with a mutation may be aggressive.
Several PARP inhibitors have received approval for treating , castraction-resistant cancer (mCRPC) in people with mutations.
- Akeega is a drug that combines the hormone therapy drug with the niraparib in a single tablet. Akeega may be used in combination with prednisone as a treatment for castration-resistant cancer (mCRPC) for people with a or mutation.
- Lynparza may be used to treat MCRPC in people who have a mutation in or another gene linked to damage repair whose cancer got worse or came back after receiving hormone therapy with (Xtandi) or (Zytiga).
- may be used to treat castration-resistant cancer in people who have already received treatment with a certain type of hormone therapy and chemotherapy.
- () may be used to treat people with , who have a mutation in or another gene linked to a certain type of damage repair.
PARP inhibitors for other advanced cancers with no treatment options
If you have a mutation and 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 .
FORCE offers many peer support programs for people with inherited mutations.
- Our Message Boards allow people to connect with others who share their situation. Once registered, you can post on the Diagnosed With Cancer board to connect with other people who have been diagnosed.
- Our Peer Navigation Program will match you with a volunteer who shares your mutation and situation.
- Our moderated, private Facebook group allows you to connect with other community members 24/7.
- Check out our virtual and in-person support meeting calendar.
- Join one of our Zoom community group meetings.
The following are cancer treatment studies enrolling people with a or mutation:
Advanced cancers of different types
- NCT04644068: Study of AZD5305 as Monotherapy and in Combination With Anti-cancer Agents in Patients With Advanced Solid Malignancies (PETRA). This research is designed to learn if treatment with a new , AZD5305, alone, or in combination with anti-cancer agents is safe, tolerable, and has anti-cancer activity in patients with advanced . The study is open to people who have previously been treated with PARP inhibitors.
- 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. The study is enrolling people with inherited mutations including , , , , and people with tumors that are HRD-positive.
- NCT04267939: ATR Inhibitor Plus Study in Advanced and Ovarian Cancer. This study will look at how well how well people with advanced respond to treatment with the tareted therapy BAY1895344 in combination with the niraparib. This study is open to people with inherited mutations in , , and others. Contact the study coordinator for information about eligilibity for people with mutations in other genes. This study is open to people whose cancer stopped responding or progressed on PARP inhibitors.
- NCT04657068: Treatment with ATR Inhibitor for Advanced or Solid Tumors. This study will look at how well a new oral known as an ATR inhibitor works on advanced or with mutations in genes linked to damage repair. This study is open to people who have an inherited or tumor or mutation or people with tumors that are HRD-positive. This study is open to people whose cancer stopped responding or progressed on PARP inhibitors.
- NCT03428802: Pembrolizumab in Treating Participants With , 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 . The study is specifically enrolling people with inherited or tumor mutations in or .
- NCT03344965: Expanded - Treating Breast Cancer in People without gBRCA Mutations. This study is looking at whether is also effective for treating breast cancer in people who do not have an inherited mutation. The study is enrolling people with an in or an acquired (tumor) mutation in or .
- NCT03911973: Gedatolisib Plus in Advanced Triple Negative or BRCA1/2 Positive, Negative Breast Cancers. This study is designed to determine efficacy of gedatolisib in combination with in advanced negative breast cancer that is triple negative or BRCA1/2 positive (deficient).
- NCT04039230: Study to Evaluate Sacituzumab Govitecan in Combination With in Patients With Breast Cancer. This studies the effect of Antibody-Drug Conjugate Sacituzumab Govitecan in Combination with the PARP Inhibitor in Patients with TNBC.
- NCT03685331: HOPE: , Palbociclib and Fulvestrant in Patients With 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 and fulvestrant, in treating people with hormone receptor-positive (HR+), , breast cancer who have a or mutation.
A number of other clinical trials for patients with breast cancer can be found here.
- NCT04915755: Using Blood Test to Screen for Cancer in People Who Completed Treatment for TNBC and/or an Inherited or Tumor Mutation; Followed by Study Comparing with for People with Cancer Detected in their Blood (ZEST).This study will enroll people with triple negative breast cancer or people with an inherited or acquired or mutation who have completed treatment (or are still in treatment with hormone therapy) for screening using circulating tumor (). People who test positive for may be eligible for a study to receive the , or a and undergo close monitoring with imaging (CT scans).
NCT04584255: Treating HER2-Negative, , or PALB2-Associated Breast Cancer with a () and (Dostarlimab). This study will look at how well the drugs (a ) and Dostarlimab (an ) treat breast cancer in people with an inherited , or mutation.
A number of other clinical trials for patients with breast cancer can be found here.
- NCT03462342 Combination ATR inhibitor and in Recurrent Ovarian Cancer (CAPRI). This study will look at how well patients with recurrent ovarian cancer respond to treatment with a type of known as an ATR inhibitor when combined with a .
- NCT04586335: Study of CYH33 in Combination With an Oral in Patients With Advanced . The purpose of this study is to assess the safety, tolerability and preliminary efficacy of the CYH33 in combination with olaprib in patients with DDR gene mutations and/or PIK3CA mutations, in patients who have progressed on prior , and in patients with recurrent high grade serous ovarian, , or primary peritoneal cancer who are platinum resistant or refractory.
- NCT03579316: Adavosertib With or Without in Treating Patients With Recurrent Ovarian, Primary Peritoneal, or Cancer. This studies how well adavosertib with or without work in patients with ovarian cancer that has come back (recurrent). The study is open to people who have previously been treated with PARP inhibitors.
- NCT04267939: ATR Inhibitor Plus Study in Advanced and Ovarian Cancer. This study will look at how well how well people with advanced ovarian cancer or other respond to treatment with the BAY1895344 in combination with the . This study is open to people whose ovarian cancer progressed on a .
- 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.
A number of other clinical trials for people with ovarian cancer can be found here.
- NCT04150042: A Study of Melphalan, BCNU, Vitamin B12b, Vitamin C and Stem Cell Infusion in People with Advanced Pancreatic Cancer and Mutations. This study will look at whether combining melphalan, BCNU, vitamin B12b and vitamin C, followed by autologous (self) bone marrow stem cell infusion, is safe and effective for treating people with advanced pancreatic cancer who have a or gene mutation.
- NCT04229004: Precision Promise Platform Trial for Pancreatic Cancer. This study tests different treatments for pancreatic cancer.
- NCT04493060: Treating Pancreatic Cancer with an Inherited or Tumor BRCA1/2 or Mutation with and Dostarlimab. This study looks at how well the and the drug dostarlimab work together in treating patients with pancreatic cancer, who have an inherited or tumor mutation in one of these genes: , , , , , or .
- NCT04666740: Pembrolizumab and for Pancreatic Cancer with or Exceptional Response to Platinum Chemotherapy. This is a study for people diagnosed with pancreatic cancer with a tumor test result called HRD-positive, or whose disease has responded well to or second-line platinum therapy. The study will look at whether combining the drug pembrolizumab and the olaparib is a more effective treatment for this cancer than taking alone.
- NCT04858334: or in Patients with Surgically Removed Pancreatic Cancer who have a , or Mutation (APOLLO). The purpose of APOLLO is to compare the usual approach (observation) to treatment for one year with a drug called , in patients with a , or mutation.
NCT04548752: Adding Pembrolizumab to to Treat Pancreatic Cancer in People with an Inherited Mutation. This study is researching whether adding the drug Pembrolizumab (Keytruda) to the Olaparib (Lynparza) works better than alone in treating people with pancreatic cancer who also have an inherited or mutation.
A number of other clinical trials for people with pancreatic cancer can be found here.
- NCT04821622: TALAPRO-3: A Clinical Trial in Men with Castration-Sensitive Cancer (mCSPC) and Damage Repair (DDR) Gene Alterations. TALAPRO-3 is a trial for men who have been diagnosed with castration-sensitive cancer (mCSPC) which means that the tumor has spread to other parts of the body but is still sensitive to hormone therapies.
- NCT05005728: XmAb®20717 Alone or in Combination With Chemotherapy or in Patients With Castration-Resistant Cancer. This study will look at the safety and clinical activity of the drug XmAb20717 alone or in combination with standard of care anticancer therapies in patients with castration-resistant cancer who have been treated with at least 2 prior lines of treatment.
- NCT03012321: Abiraterone/Prednisone, , or Abiraterone/Prednisone + in Patients With Castration-Resistant Cancer With Repair Defects. This is a phase II study in men with castration resistant cancer (mCRPC) open to men with a or other mutation.
- NCT04455750: A Clinical Study Evaluating The Benefit of Adding to for Men With Prostate Cancer That Has Become Resistant To Testosterone-Deprivation Therapy. This trial is evaluating the benefit of and combination therapy versus alone for the treatment of men with prostate cancer that has become resistant to testosterone-deprivation therapy.
- NCT04030559: Before Surgery in Treating Patients With High Risk Localized Cancer and Damage Response Defects. This study will look at how well the niraparib works, when given before a radical prostatectomy, for people with high-risk cancer that has not spread to other parts of the body, and who have a tumor mutation in any of the following genes:BRCA1/2, , CDK12, CHEK1/2 FANCA, FANCD2, FANCL, GEN1, , , RAD51, , and .
- NCT04194554: Androgen Suppression With , Leuprolide, and Stereotactic Radiotherapy in Cancer (ASCLEPIuS). This study will look at treating men with high risk cancer using the niraparib combined with stereotactic body radiotherapy (SBRT), , leuprolide, and prednisone.
A number of other clinical trials enrolling people with cancer can be found by searching here.