NEJM Quick Take: Improving outcomes in ovarian cancer
“Progress in BRCA-Mutated Ovarian Cancer
Nearly all the patients in the SOLO1 trial had a germ-line mutation in BRCA1 or BRCA2 (BRCA1/2), and the results may not be generalizable to patients with either somatic BRCA mutations or wild-type BRCA genes. Despite a request from the Journal, Myriad Genetics has declined to provide the actual identity and distribution of the genetic variants detected
There were very real toxic effects, primarily related to the myelo-suppression that so commonly occurs with cancer treatments, and less than 50% of the patients in the olaparib group completed the 2-year treatment plan.
Will the dramatic improvement in progression-free survival translate to an overall survival benefit or even an improved cure rate?
Could long-term use of agents that interfere with repair of double-stranded DNA breaks result in the development of the myelodysplastic syndrome and acute leukemia?
Additional studies will be needed to evaluate the effect of PARP inhibitors in other, less susceptible populations, including patients who have other defects in the repair of double-stranded DNA breaks, somatic (tumor) BRCA1 mutations, epigenetically silenced BRCA1/2 expression, or even intact BRCA1/2 function in the context of ovarian cancer”.
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