Experience in treating BRCA-associated breast cancer. The BRCA-history of a family

Abstract

Breast cancer (BC) is the most common cancer and the primary cause of cancer death. About 5 to 10% of breast cancer cases have a hereditary background. BRCA-related breast cancer is characterized by more aggressive phenotype than sporadic breast cancer. Olaparib is one of the drugs that can improve the results of treatment in this group of patients. Several phase I and II trials have shown that PARP inhibitors are effective as monotherapy in patients with metastatic breast cancer and germline BRCA1/2 mutation. A randomized, open-label, phase III trial (the OlympiAD study) comparing olaparib monotherapy and standard treatment in patients with HER2-negative mBC and a germline BRCA1/2 mutation showed hopeful results. The olaparib group registered an objective response of 59.9% compared to 28.8% in the standard therapy. A complete response was reported for 9.0% of patients in the olaparib group and 1.5% in the standard therapy group. A clinical case of treatment of a triple-negative breast cancer patient with BRCA1 c.5382insC (rs80357906) mutation is presented. There was a response to over 9-month olaparib therapy after progression on two systemic chemotherapy lines. The pedigree of the patient was also considered, her relatives with malignant tumours were identified. Screening tests were done to detect the patient’s relatives with a germline mutation in the BRCA1 gene. More thorough tests are planned to be done for early detection of malignant neoplasms in the identified healthy relatives with BRCA1 c.5382insC mutation.

Keywords

• hereditary breast cancer
• germline mutations
• brca1/2 gene
• pedigree
• healthy carriers of mutations
• parp inhibitors
• olaparib