Research & Clinical Trials

FORCE has a strong commitment to promoting research to benefit our community. We advocate for more research funding, educate people about available studies, and report findings back to our community.

Research & Clinical Trials > Research Findings > Research Highlights from ASCO 2014

Highlights from ASCO 2014

by Lisa Rezende, PhD

Majority of women who undergo risk-reducing salpingo-oophorectomy report quality of life issues

Dr. Susan Domchek from the Basser Research Center for BRCA presented research on the quality of life of BRCA mutation carriers after risk-reducing salpingo-oophorectomy. The study included 789 BRCA mutation carriers who elected to remove their ovaries and fallopian tubes to manage breast and/or ovarian cancer risk. Dr. Domchek noted that FORCE recruited close to 90% of the study’s participants.

Early reports from the study show that majority of patients showed significant quality of life issues, including:

  • 59% reporting symptoms of stress
  • 51% reporting menopausal hot flashes
  • 76% reporting sexual issues
  • 59% reporting sleep issues

Women on hormone replacement therapy (HRT) reported fewer hot flashes and sexual issues than those who were not. Only 23% of women in the study were currently taking HRT, with 35% saying that they had ever taken HRT. We look forward to more data from this study, including the results from memory tests.

Why is this study important? For many women in surgical menopause these symptoms are familiar. This work demonstrates the extent of the problem to the medical and research communities. For researchers, it is a critical first step to support research into finding the best way to manage surgical menopause. The importance of this study to health care providers was apparent during the presentation at ASCO. A physician noted that these symptoms are not trivial and must be taken into account in follow-up care of BRCA mutation carriers who undergo risk-reducing salpingo-oophorectomy.

Multiplex testing to assess cancer risk
New genetic tests that look at multiple genes were front and center at ASCO this year, with a session devoted to the topic. Genetics experts presented research papers and conducted educational sessions of this rapidly changing field. A few highlights included:

  • Dr. Kara Maxwell and colleagues at the Basser Center for BRCA sequenced DNA from 277 women with early-onset breast cancer who tested negative for BRCA1 or BRCA2 mutations. Looking for mutations in 19 different genes that are associated with increased cancer risk, the researchers found that 30% of the women had mutations in one or more of these genes, while only 2.5% had mutations in genes with defined clinical guidelines for managing cancer risk.
  • Dr. Lucy Langer and colleagues of Northwest Cancer Specialists reported the results of using a 25-gene panel to test 263 women diagnosed with ovarian cancer. These researchers found mutations in at least one gene associated with cancer risk in 16.3% of the women tested; 60% of the mutations were in BRCA1 or BRCA2, and 5.8% of mutations were in a gene that causes Lynch Syndrome, a hereditary cancer syndrome associated with increased risk of colon and other cancers.
  • Dr. Matthew Yurgelun of the Dana Farber Cancer Institute presented the results of a study using multiple gene panels to screen 1,260 patients who had been previously tested for Lynch Syndrome. He found that 155 patients had mutations in genes known to increase cancer risk´┐Ż73% of the mutations were in genes associated with Lynch Syndrome. The remaining patients had mutations in other genes, including 10 patients with mutations in BRCA1 or BRCA2.

PARP inhibitor combined with a second drug increases survival in women with recurrent ovarian cancer
Dr. Joyce Liu of Dana-Farber Cancer Institute presented results from a phase II trial that compared treatment with olaparib (a PARP inhibitor) alone, to olaparib in combination with the drug cediranib. The trial enrolled 90 patients with ovarian cancer that had recurred after initial treatment. Some patients had a mutation in BRCA1 or BRCA2, while others did not. Half of the patients were given olaparib alone while the other half received both olaparib and cediranib. Progression-free survival for patients given olaparib and cediranib was almost twice as long (17.7 months) as those who were given only olaparib (9 months). Current therapy for recurrent ovarian cancer has an average progression-free survival time of 8-13 months.

Other PARP inhibitor news

  • A phase I/II trial of the PARP inhibitor rucaparib found that 89% of ovarian cancer patients with a BRCA mutation responded to the drug. Phase II and III studies will compare the response of rucaparib given alone to the response of rucaparib combined with standard chemotherapy.
  • A phase I trial involving 60 BRCA mutation carriers with breast, ovarian, pancreatic, or prostate cancer who received the PARP inhibitor veliparib showed that the drug is well tolerated. Phase II trials of veliparib are ongoing.

BRCA mutations in African American breast cancer survivors
Dr. Tuya Pal of Moffitt Cancer Center presented her study showing that BRCA1 and BRCA2 mutations are more common in black breast cancer survivors under age 50 than previously thought, with 28 of 283 women (9.9%) testing positive for BRCA mutations. Dr. Pal noted that although all 283 women qualified for referral to genetic counseling under current national guidelines, only about one-third were tested prior to the study.

Removal of ovaries was associated with increased survival for breast cancer survivors with BRCA1 mutations
Surgical removal of the ovaries and fallopian tubes is associated with increased survival among BRCA mutation carriers. In a new report, Dr. Kelly Metcalfe of the University of Toronto presented work that followed BRCA mutation carriers for up to 20 years after being diagnosed with early-stage breast cancer. The survival rate for BRCA1 mutation carriers with breast cancer was higher among women who removed their ovaries, even after adjusting for clinical features and other treatments. The greatest increase in survival was observed among BRCA1 mutation carriers with estrogen receptor-negative breast cancer.

Preserving fertility of premenopausal breast cancer patients
Women with early breast cancer who are treated with chemotherapy that includes the drug cyclophosphamide sometimes experience ovarian failure after treatment has ended. Dr. Halle Moore of the Cleveland Clinic presented data from a phase III trial that showed combining the drug goserelin with chemotherapy helps to preserve fertility. Patients were followed for 2 years after treatment: 45% of the women who received standard chemotherapy had ovarian failure, while only 20% of those whose treatment included goserelin had ovarian failure. Women from both groups had successful pregnancies after fertility was restored.

Growing up in a family with breast cancer risk
Dr. Angela Bradbury and colleagues at the Perelman School of Medicine, University of Pennsylvania, compared cancer-related worry, anxiety, and depression in teenage girls from families at increased risk of breast cancer to teenage girls at normal risk. High-risk was defined as having a known familial mutation in BRCA1 or BRCA2 or having at least one relative with breast cancer. Teenage girls from high-risk families had higher general anxiety and more breast-cancer related worry than those from families at average risk; they were also more likely to perform breast self-exams. No differences between the two groups were apparent in risky behavior or preventative healthy behaviors.

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