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ASCO 2012 Highlights

by Clayton Boldt

This year’s annual meeting of the American Society of Clinical Oncology (ASCO) featured many presentations, including research of hereditary breast and ovarian cancer.

Prostate cancer risk is increased and may behave more aggressively in men with BRCA mutations, especially men with BRCA2 mutations. The Institute of Cancer Research in London is looking for new biomarkers to improve early screening for prostate cancer in high-risk men. Preliminary research using samples collected in the international IMPACT study (ongoing research looking at the benefit of PSA screenings in men with and without mutations) indicated that levels of the protein EN2 could help to detect prostate cancer in patients with mutations; higher levels appear to be associated with more aggressive cancers. Additional research is needed to see if these findings will lead to a better method of prostate cancer screening.

Representatives from Moffitt Cancer Center presented the results of their pilot study of survey data from FORCE members, suggesting that mutation carriers may be at higher risk for cardiac complications following anthrocycline (a type of chemotherapy that includes Adriamycin) treatment. Researchers plan more comprehensive studies to better learn about this risk.

The large GOG-199 collaborative study investigated tumor incidence in women undergoing risk-reducing bilateral salpingo-oophorectomy (BSO), a standard option to prevent ovarian cancer in women who have BRCA1/2 mutations; the actual prevalence of ovarian cancers in this risk group is unclear. Among BRCA mutation carriers undergoing BSO, unsuspected ovarian, fallopian tube, or primary peritoneal tumors were found in 3.2% of women at the time of surgery, compared to 0.5% among non-carriers. This data is critical for advising BRCA1/2 carriers contemplating this surgery as a risk-reduction strategy.

Several presentations focused on studies of therapeutic options, including platinum-based chemotherapy and PARP inhibitors. Individuals with BRCA mutations carry an increased risk for pancreatic cancer—patients with this disease have limited response to standard chemotherapy, and platinum-based treatments do little to improve prognosis. A Toronto research team conducted a small retrospective study that showed improved response and survival in mutation carriers who received platinum chemotherapy for pancreatic cancer compared to other therapies. PARP inhibitors have also shown promise in treating cancers deficient in BRCA1/2, and several related studies were presented this year. Preliminary research on one PARP inhibitor, veliparib, suggests it may be effective in treating BRCA-related cancers and some sporadic cancers. Veliparib seems to improve response when combined with the platinum-based therapy, carboplatin, but not when combined with cyclophosphamide. Another PARP inhibitor, olaparib, may effectively treat breast and ovarian cancers. These therapies appear to be tolerated well, and additional trials are ongoing.

Visit www.asco.org to view or download the abstracts.

Clayton R. Boldt is a doctoral graduate student in the Genetics and Development program at UT Southwestern Medical Center in Dallas. He is interested in cancer biology, and researches pediatric germ cell tumor development in his thesis work.

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