New research has identified which groups of women with ovarian cancer have better outcomes on platinum chemotherapy treatment.
Previous research has shown that ovarian cancer patients with a mutated BRCA1 gene live longer with platinum chemotherapy and new DNA repairing treatments than patients without the mutation.
So a team led by Professor Bryan Hennessy at the Royal College of Surgeons in Ireland analysed figures on 2,636 women with ovarian cancer taking part in 15 studies.
They investigated whether these treatments could also benefit patients whose BRCA1 gene has changed in a way that is thought to silence it.
Analysis showed that both the mutated and silenced BRCA1 gene were linked to more serious cases, diagnosed at a younger age, than in women without a mutated or silenced gene.
A difference was seen in patients with the silenced gene – they tended to show faulty DNA repair more often than those with a mutated gene. Both groups appeared to have similar responses to platinum chemotherapy, but this could be due to different methods of testing the genes. When reliable methods were used, patients with a BRCA1 silenced gene had better survival after the platinum chemotherapy treatment.
Details were published in the Journal of the National Cancer Institute on Monday (8 June).
Co-author Roshni Kalachand said: "We found that the studies that used a specific methylation PCR [polymerase chain reaction] test showed the results that we would expect for those with truly silenced BRCA1 gene. This suggests that researchers need to refine and standardise the way they test for silencing of this gene."
Kalachand, R. D. et al. BRCA1 promoter methylation and clinical outcomes in ovarian cancer: an individual patient data meta-analysis. Journal of the National Cancer Institute 8 June 2020; doi: 10.1093/jnci/djaa070
https://academic.oup.com/jnci/advance-article-abstract/doi/10.1093/jnci/djaa070/5837681
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