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Kalampokis N, Zabaftis C, Spinos T, Karavitakis M, Leotsakos I, Katafigiotis I, van der Poel H, Grivas N, Mitropoulos D. Review on the Role of BRCA Mutations in Genomic Screening and Risk Stratification of Prostate Cancer. Curr Oncol 2024; 31:1162-1169. [PMID: 38534919 PMCID: PMC10969585 DOI: 10.3390/curroncol31030086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 05/26/2024] Open
Abstract
(1) Background: Somatic and germline alterations can be commonly found in prostate cancer (PCa) patients. The aim of our present study was to perform a comprehensive review of the current literature in order to examine the impact of BRCA mutations in the context of PCa as well as their significance as genetic biomarkers. (2) Methods: A narrative review of all the available literature was performed. Only "landmark" publications were included. (3) Results: Overall, the number of PCa patients who harbor a BRCA2 mutation range between 1.2% and 3.2%. However, BRCA2 and BRCA1 mutations are responsible for most cases of hereditary PCa, increasing the risk by 3-8.6 times and up to 4 times, respectively. These mutations are correlated with aggressive disease and poor prognosis. Gene testing should be offered to patients with metastatic PCa, those with 2-3 first-degree relatives with PCa, or those aged < 55 and with one close relative with breast (age ≤ 50 years) or invasive ovarian cancer. (4) Conclusions: The individualized assessment of BRCA mutations is an important tool for the risk stratification of PCa patients. It is also a population screening tool which can guide our risk assessment strategies and achieve better results for our patients and their families.
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Affiliation(s)
- Nikolaos Kalampokis
- Department of Urology, G. Hatzikosta General Hospital, 45001 Ioannina, Greece;
| | - Christos Zabaftis
- Department of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, PC 11528 Athens, Greece; (C.Z.); (M.K.); (I.L.); (I.K.)
| | - Theodoros Spinos
- Department of Urology, University of Patras Hospital, 26504 Patras, Greece;
| | - Markos Karavitakis
- Department of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, PC 11528 Athens, Greece; (C.Z.); (M.K.); (I.L.); (I.K.)
| | - Ioannis Leotsakos
- Department of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, PC 11528 Athens, Greece; (C.Z.); (M.K.); (I.L.); (I.K.)
| | - Ioannis Katafigiotis
- Department of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, PC 11528 Athens, Greece; (C.Z.); (M.K.); (I.L.); (I.K.)
| | - Henk van der Poel
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands;
| | - Nikolaos Grivas
- Department of Laparoscopy and Endourology, Central Urology, Lefkos Stavros the Athens Clinic, PC 11528 Athens, Greece; (C.Z.); (M.K.); (I.L.); (I.K.)
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands;
| | - Dionysios Mitropoulos
- Department of Urology, Medical School, National & Kapodistrian University of Athens, 14122 Athens, Greece;
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2
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Valsecchi AA, Dionisio R, Panepinto O, Paparo J, Palicelli A, Vignani F, Di Maio M. Frequency of Germline and Somatic BRCA1 and BRCA2 Mutations in Prostate Cancer: An Updated Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15092435. [PMID: 37173901 PMCID: PMC10177599 DOI: 10.3390/cancers15092435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/05/2023] [Accepted: 04/22/2023] [Indexed: 05/15/2023] Open
Abstract
In prostate cancer (PC), the presence of BRCA somatic and/or germline mutation provides prognostic and predictive information. Meta-analysis aims to estimate the frequency of BRCA mutations in patients with PC (PCp). In November 2022, we reviewed literature searching for all articles testing the proportion of BRCA mutations in PCp, without explicit enrichment for familiar risk. The frequency of germline and somatic BRCA1 and/or BRCA2 mutations was described in three stage disease populations (any/metastatic/metastatic castration-resistant PC, mCRPC). Out of 2253 identified articles, 40 were eligible. Here, 0.73% and 1.20% of any stage PCp, 0.94% and 1.10% of metastatic PCp, and 1.21% and 1.10% of mCRPC patients carried germline and somatic BRCA1 mutation, respectively; 3.25% and 6.29% of any stage PCp, 4.51% and 10.26% of metastatic PCp, and 3.90% and 10.52% of mCRPC patients carried germline and somatic BRCA2 mutation, respectively; and 4.47% and 7.18% of any stage PCp, 5.84% and 10.94% of metastatic PCp, and 5.26% and 11.26% of mCRPC patients carried germline and somatic BRCA1/2 mutation, respectively. Somatic mutations are more common than germline and BRCA2 are more common than BRCA1 mutations; the frequency of mutations is higher in the metastatic setting. Despite that BRCA testing in PC is now standard in clinical practice, several open questions remain.
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Affiliation(s)
- Anna Amela Valsecchi
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
| | - Rossana Dionisio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
| | - Olimpia Panepinto
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
| | - Jessica Paparo
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Francesca Vignani
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
| | - Massimo Di Maio
- Department of Oncology, University of Turin, Ordine Mauriziano Hospital, 10128 Turin, Italy
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Lapini A, Caffo O, Conti GN, Pappagallo G, Del Re M, D'Angelillo RM, Capoluongo ED, Castiglione F, Brunelli M, Iacovelli R, De Giorgi U, Bracarda S. Matching BRCA and prostate cancer in a public health system: Report of the Italian Society for Uro-Oncology (SIUrO) consensus project. Crit Rev Oncol Hematol 2023; 184:103959. [PMID: 36921782 DOI: 10.1016/j.critrevonc.2023.103959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/16/2023] Open
Abstract
The recent approval of PARP inhibitors for the treatment of metastatic -castration-resistant prostate cancer (mCRPC) patients with BRCA mutations firstly introduced the possibility of proposing a targeted treatment in this disease. However, the availability of this therapeutic option raises a number of questions concerning the management of prostate cancer in everyday clinical practice: the timing and method of detecting BRCA mutations, the therapeutic implications of the detection, and the screening of the members of the family of a prostate cancer patient with a BRCA alteration. These challenging issues led the Italian Society for Uro-Oncology (SIUrO) to organise a Consensus Conference aimed to develop suggestions capable of supporting clinicians managing prostate cancer patients. The present paper described the development of the statements discussed during the consensus, which involved all of the most important Italian scientific societies engaged in the multi-disciplinary and multi-professional management of the disease.
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Affiliation(s)
- Alberto Lapini
- Department of Urology, University of Florence, University Hospital of Florence, Largo Brambilla, 3, 50134 Florence, Italy
| | - Orazio Caffo
- Department of Medical Oncology, Santa Chiara Hospital, Largo Medaglie d'Oro, 38122 Trento, Italy.
| | - Giario Natale Conti
- Italian Society for Uro-Oncology (SIURO), Via Dante 17, 40125 Bologna, Italy
| | - Giovanni Pappagallo
- IRCCS "Sacro Cuore - Don Calabria", Viale Luigi Rizzardi, 4, 37024 Negrar di Valpolicella, Italy
| | - Marzia Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
| | - Rolando Maria D'Angelillo
- Radiation Oncology, Department of Biomedicine and Prevention University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy
| | - Ettore Domenico Capoluongo
- Department of Molecular Medicine and Medical Biotechnologies, University Federico II, Via Pansini 5, 80131 Naples, Italy; Department of Clinical Pathology and Genomics, Azienda Ospedaliera per L'Emergenza Cannizzaro, Via Messina 829, 95126 Catania, Italy
| | - Francesca Castiglione
- Department of Pathology, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
| | - Matteo Brunelli
- Unit of Pathology, Department of Diagnostics and Public Health, University of Verona, P.le L.A. Scuro 10, 37134 Verona, Italy
| | - Roberto Iacovelli
- Medical Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Ugo De Giorgi
- Unit of Medical Oncology, IRCCS-Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via Maroncelli 40, 47014 Meldola, Italy
| | - Sergio Bracarda
- Medical and Translational Oncology, Department of Oncology, Azienda Ospedaliera Santa Maria, Viale Tristano di Joannuccio, 05100 Terni, Italy
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Cioffi A, De Cobelli O, Veronesi P, La Vecchia C, Maisonneuve P, Corso G. Prevalence of Germline BRCA1/2 Variants in Ashkenazi and Non-Ashkenazi Prostate Cancer Populations: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15010306. [PMID: 36612302 PMCID: PMC9818251 DOI: 10.3390/cancers15010306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND AIMS International guidelines recommend testing BRCA2 in men with prostate cancer, due to the presence of a strong association with this gene. Some ethnicities present disparities in genetic distribution for the relation with specific founder variants. Ashkenazi Jewish people are, importantly, at high risk of breast cancer for their inherited cluster with germline BRCA1/2 variants. However, in Ashkenazi men with prostate cancer, the prevalence of BRCA1 and/or BRCA2 is not well defined. We assessed the frequency of these variants in Ashkenazi vs. non-Ashkenazi men with prostate cancer. Materials and Methods: In accord with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, we revised all germline BRCA variants reported in MEDLINE from 1996 to 2021 in Ashkenazi and non-Ashkenazi men with prostate cancer. Results: Thirty-five original studies were selected for the analysis. Among populations from Israel and North America, Ashkenazi Jewish men presented higher prevalence of BRCA1 variants [0.9% (0.4-1.5) vs. 0.5% (0.2-1.1), p = 0.09] and a lower prevalence of BRCA2 variants [1.5% (1.1-2.0) vs. 3.5% (1.7-5.9), p = 0.08] in comparison to the non-Ashkenazi population. Conclusions: Since germline BRCA1 variants are more prevalent and BRCA2 variants are less prevalent in PCa patients of Ashkenazi Jewish ethnicity in comparison to non-Ashkenazi patients, prostate cancer genetic screening in Ashkenazi men should not be restricted to the BRCA2 gene.
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Affiliation(s)
- Antonio Cioffi
- Division of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
| | - Ottavio De Cobelli
- Division of Urology, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
| | - Paolo Veronesi
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
| | - Giovanni Corso
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy
- Division of Breast Surgery, European Institute of Oncology (IEO), IRCCS, 20141 Milan, Italy
- European Cancer Prevention Organization (ECP), 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-9437-5161
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5
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Zhang D, Xu X, Wei Y, Chen X, Li G, Lu Z, Zhang X, Ren X, Wang S, Qin C. Prognostic Role of DNA Damage Response Genes Mutations and their Association With the Sensitivity of Olaparib in Prostate Cancer Patients. Cancer Control 2022; 29:10732748221129451. [PMID: 36283420 PMCID: PMC9608002 DOI: 10.1177/10732748221129451] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Evidence shows that gene mutation is a significant proportion of genetic factors associated with prostate cancer. The DNA damage response (DDR) is a signal cascade network that aims to maintain genomic integrity in cells. This comprehensive study was performed to determine the link between different DNA damage response gene mutations and prostate cancer. Materials and methods A systematic literature search was performed using PubMed, Web of Science, and Embase. Papers published up to February 1, 2022 were retrieved. The DDR gene mutations associated with prostate cancer were identified by referring to relevant research and review articles. Data of prostate cancer patients from multiple PCa cohorts were obtained from cBioPortal. The OR or HR and 95% CIs were calculated using both fixed-effects models (FEMs) and random-effects models (REMs). Results Seventy-four studies were included in this research, and the frequency of 13 DDR genes was examined. Through the analysis of 33 articles that focused on the risk estimates of DDR genes between normal people and PCa patients, DDR genes were found to be more common in prostate cancer patients (OR = 3.6293 95% CI [2.4992; 5.2705]). Also, patients in the mutated group had a worse OS and DFS outcome than those in the unmutated group (P < .05). Of the 13 DDR genes, the frequency of 9 DDR genes in prostate cancer was less than 1%, and despite differences in race, BRCA2 was the potential gene with the highest frequency (REM Frequency = .0400, 95% CI .0324 - .0541). The findings suggest that mutations in genes such as ATR, BLM, and MLH1 in PCa patients may increase the sensitivity of Olaparib, a PARP inhibitor. Conclusion These results demonstrate that mutation in any DDR pathway results in a poor prognosis for PCa patients. Furthermore, mutations in ATR, BLM, and MLH1 or the expression of POLR2L, PMS1, FANCE, and other genes significantly influence Olaparib sensitivity, which may be underlying therapeutic targets in the future.
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Affiliation(s)
- Dong Zhang
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xinchi Xu
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yuang Wei
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xinglin Chen
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Guangyao Li
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhongwen Lu
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xu Zhang
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiaohan Ren
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shangqian Wang
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China,Chao Qin, The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. ; Shangqian Wang, The State Key Lab of Reproductive; Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Chao Qin
- The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China,Chao Qin, The State Key Lab of Reproductive, Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. ; Shangqian Wang, The State Key Lab of Reproductive; Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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6
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Nyberg T, Tischkowitz M, Antoniou AC. BRCA1 and BRCA2 pathogenic variants and prostate cancer risk: systematic review and meta-analysis. Br J Cancer 2022; 126:1067-1081. [PMID: 34963702 PMCID: PMC8979955 DOI: 10.1038/s41416-021-01675-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/28/2021] [Accepted: 12/10/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND BRCA1 and BRCA2 pathogenic variants (PVs) are associated with prostate cancer (PCa) risk, but a wide range of relative risks (RRs) has been reported. METHODS We systematically searched PubMed, Embase, MEDLINE and Cochrane Library in June 2021 for studies that estimated PCa RRs for male BRCA1/2 carriers, with no time or language restrictions. The literature search identified 27 studies (BRCA1: n = 20, BRCA2: n = 21). RESULTS The heterogeneity between the published estimates was high (BRCA1: I2 = 30%, BRCA2: I2 = 83%); this could partly be explained by selection for age, family history or aggressive disease, and study-level differences in ethnicity composition, use of historical controls, and location of PVs within BRCA2. The pooled RRs were 2.08 (95% CI 1.38-3.12) for Ashkenazi Jewish BRCA2 carriers, 4.35 (95% CI 3.50-5.41) for non-Ashkenazi European ancestry BRCA2 carriers, and 1.18 (95% CI 0.95-1.47) for BRCA1 carriers. At ages <65 years, the RRs were 7.14 (95% CI 5.33-9.56) for non-Ashkenazi European ancestry BRCA2 and 1.78 (95% CI 1.09-2.91) for BRCA1 carriers. CONCLUSIONS These PCa risk estimates will assist in guiding clinical management. The study-level subgroup analyses indicate that risks may be modified by age and ethnicity, and for BRCA2 carriers by PV location within the gene, which may guide future risk-estimation studies.
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Affiliation(s)
- Tommy Nyberg
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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7
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Laforet PE, Yalamanchili B, Hillyer GC, Basch CH. YouTube as an information source on BRCA mutations: implications for patients and professionals. J Community Genet 2022; 13:257-262. [PMID: 35023041 DOI: 10.1007/s12687-022-00576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022] Open
Abstract
Genetic testing for BRCA1/2 mutations in early breast cancer has been shown to be beneficial, and an increase in surveillance using these genetic markers is recommended. Given this recommendation, it is likely that individuals gather information about such testing. Social media is increasingly becoming a common source of health information. One such platform known for sharing health information is YouTube. The purpose of this study was to describe content related to BRCA1/2 mutations on YouTube. The sample included 100 English language videos, which were coded for content related to BRCA1/2 mutations. The 100 videos evaluated in this study were viewed 5.5 million times. In general, the BRCA1 and BRCA2 gene mutations were mentioned simultaneously, with only 15% of videos explaining the difference in prevalence or implication of the variants individually. A great number of videos (85.0%) discussed having genetic testing to determine the presence of BRCA mutations, but only 16.0% discussed the potential harms of BRCA mutation testing and 42.0% mentioned seeking genetic counseling to determine the need for testing and interpretation of the test results. Comparing the characteristics and content of videos created by healthcare professionals (n = 71) to those created by consumers and the media (n = 29), we found that consumer/media videos were viewed twice as many times as professional videos (3,704,351 vs. 1,851,825, p = 0.04). Videos from medical professionals should include consistent information on the recommendations for individuals who test positive for a BRCA mutation. Such content should include education about BRCA mutations, testing, implications of those results and ways to reduce risk, and recommendations for increased surveillance and enhanced screening for individuals positive for BRCA mutations.
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Affiliation(s)
- Priscila E Laforet
- Department of Epidemiology, Mailman School of Public Health, Columbia University NY, New York, NY, 10032, USA
| | - Bhavya Yalamanchili
- Department of Public Health, William Paterson University, University Hall, Wayne, NJ, 07470, USA
| | - Grace C Hillyer
- Department of Epidemiology, Mailman School of Public Health, Columbia University NY, New York, NY, 10032, USA
| | - Corey H Basch
- Department of Public Health, William Paterson University, University Hall, Wayne, NJ, 07470, USA.
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Advances and challenges in cancer treatment and nutraceutical prevention: the possible role of dietary phenols in BRCA regulation. PHYTOCHEMISTRY REVIEWS 2021. [DOI: 10.1007/s11101-021-09771-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AbstractOver the years, the attention towards the role of phytochemicals in dietary natural products in reducing the risk of developing cancer is rising. Cancer is the second primary cause of mortality worldwide. The current therapeutic options for cancer treatment are surgical excision, immunotherapy, chemotherapy, and radiotherapy. Unfortunately, in case of metastases or chemoresistance, the treatment options become very limited. Despite the advances in medical and pharmaceutical sciences, the impact of available treatments on survival is not satisfactory. Recently, natural products are a great deal of interest as potential anti-cancer agents. Among them, phenolic compounds have gained a great deal of interest, thanks to their anti-cancer activity. The present review focuses on the suppression of cancer by targeting BRCA gene expression using dietary polyphenols, as well as the clinical aspects of polyphenolic agents in cancer therapy. They regulate specific key processes involved in cancer progression and modulate the expression of oncogenic proteins, like p27, p21, and p53, which may lead to apoptosis, cell cycle arrest, inhibition of cell proliferation, and, consequently, cancer suppression. Thus, one of the mechanisms underlying the anti-cancer activity of phenolics involves the regulation of tumor suppressor genes. Among them, the BRCA genes, with the two forms (BRCA-1 and BRCA-2), play a pivotal role in cancer protection and prevention. BRCA germline mutations are associated with an increased risk of developing several types of cancers, including ovarian, breast, and prostate cancers. BRCA genes also play a key role in the sensitivity and response of cancer cells to specific pharmacological treatments. As the importance of BRCA-1 and BRCA-2 in reducing cancer invasiveness, repairing DNA damages, oncosoppression, and cell cycle checkpoint, their regulation by natural molecules has been examined.
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9
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Salmi F, Maachi F, Tazzite A, Aboutaib R, Fekkak J, Azeddoug H, Jouhadi H. Next-generation sequencing of BRCA1 and BRCA2 genes in Moroccan prostate cancer patients with positive family history. PLoS One 2021; 16:e0254101. [PMID: 34242281 PMCID: PMC8270444 DOI: 10.1371/journal.pone.0254101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/18/2021] [Indexed: 12/14/2022] Open
Abstract
Prostate cancer is the most common male cancer in Morocco. Although sporadic forms account for a large proportion of patients, familial forms of prostate cancer are observed in 20% of cases and about 5% are due to hereditary transmission. Indeed, germline mutations in BRCA1/2 genes have been associated with prostate cancer risk. However, the spectrum of these mutations was not investigated in Moroccan Prostate cancer patients. Thereby, the aim of this study was to characterize and to estimate the prevalence of germline BRCA1/2 mutations and large rearrangements in Moroccan patients with familial prostate cancer. The entire coding regions and intron/exon boundaries of BRCA1 and BRCA2 genes have been analyzed by next generation sequencing (NGS) in a total of 30 familial prostate cancer patients. Three pathogenic mutations were detected in four unrelated patients (13.3%). One BRCA1 mutation (c.1953_1956delGAAA) and two BRCA2 mutations (c.7234_7235insG and BRCA2ΔE12). In addition, sixty-three distinct polymorphisms and unclassified variants have been found. Early identification of germline BRCA1/2 mutations may be relevant for the management of Moroccan prostate cancer patients.
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Affiliation(s)
- Fatiha Salmi
- Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
- * E-mail:
| | - Fatima Maachi
- Helicobacter Pylori and Gastric Pathologies Laboratory, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Amal Tazzite
- Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Rachid Aboutaib
- Department of Urology, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Jamal Fekkak
- Molecular Biology Department, Anoual Laboratory, Casablanca, Morocco
| | - Houssine Azeddoug
- Faculty of Sciences-Biochemistry and Molecular Biology Laboratory, University Hassan II Casablanca, Casablanca, Morocco
| | - Hassan Jouhadi
- Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
- Mohammed VI Center for Cancer Treatment, Ibn Rochd University Hospital Center, Casablanca, Morocco
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10
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Amsi PT, Yahaya JJ, Kalungi S, Odida M. Immunohistochemical expression of BRCA1 and BRCA2 in a cohort of Ugandan men with prostate cancer: an analytical cross-sectional study. AFRICAN JOURNAL OF UROLOGY 2020. [DOI: 10.1186/s12301-020-00079-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Mutation of the tumour suppressor genes BRCA1 and BRCA2 is thought to cause early development of prostate cancer which has poor prognosis. The purpose of this study was to determine the expression of BRCA1/2 and correlate it with clinicopathological factors for patients with prostate cancer in uganda.
Methods
Retrospectively, we used immunohistochemistry to evaluate the expression of BRCA1/2 antibodies in tissue blocks of 188 patients with prostate cancer who were diagnosed between January 2005 and December 2014 in the Department of Pathology, Makerere College of Health Sciences. The Chi-Square test was used to determine the association of the categorical variables, whereas t-test was used to compare groups of mean of the variables in the study.
Results
Expression of BRCA1 and BRCA2 was found in 26.1% and 22.9% cases, respectively. Co-expression of BRCA1 and BRCA2 was found in only 7.4%. Gleason score was associated with expression of BRCA1 and BRCA2 (P = 0.013, P = 0.041, respectively). Age was not associated with BRCA1 and BRCA2 expression; P = 0.543, P = 0.091, respectively. Likewise, PSA was not associated with BRCA1 and BRCA2 expression; P = 0.446, P = 0.399, respectively.
Conclusion
BRCA1 and BRCA2 proteins in this study were expressed more in cases with poorly differentiated prostate cancer than in cases with either well or moderately differentiated prostate cancer. Co-expression of BRCA1 and BRCA2 proteins in the same patient in our study was 3 times less than either BRCA1 or BRCA2 alone.
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11
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Sun P, Li Y, Chao X, Li J, Luo R, Li M, He J. Clinical characteristics and prognostic implications of BRCA-associated tumors in males: a pan-tumor survey. BMC Cancer 2020; 20:994. [PMID: 33054725 PMCID: PMC7556962 DOI: 10.1186/s12885-020-07481-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The BRCA mutation (BRCAm) in males has been reported to confer a higher risk for the development of various tumors. However, little is known about its clinicopathologic features and prognostic implications. DESIGN We conducted a retrospective pan-tumor survey on 346 cases of BRCA-associated tumors in males. Comparative analyses were conducted among male and female patients with BRCAm (n = 349), as well as in male patients without BRCAm (n = 4577). RESULTS Similar incidences of BRCAm (6.0 vs. 6.6%) and age at diagnosis of tumor (median, 65 vs. 60 years) were observed in male and female patients. Carcinomas of the lung, bladder, stomach, and cutaneous melanoma were the frequent tumors demonstrating BRCAm in males, of which the majority were stage II or III diseases with a higher frequency of BRCA2 mutations. Compared to that in the non-BRCAm group, cutaneous melanoma (16.3 vs. 5.0%), lung cancer (19.4 vs. 11.8%), bladder cancer (15.6 vs. 5.6%), and stomach cancer (11.9 vs. 5.5%) accounted for a higher proportion in the BRCAm group. Advanced disease and more mutation counts (median, 322 vs. 63 mutations) were also found in the BRCAm group. A total of 127 BRCA1 and 311 BRCA2 mutations were identified, of which 21.8 and 28.6% were deleterious, respectively. Frequent deleterious variants were identified in carcinomas of the breast (100.0%), colorectum (62.2%), prostate (43.3%), and stomach (42.9%). BRCA1 fusions with NF1, FAM134C, BECN1, or LSM12 and recurrent BRCA2 mutations at P606L/S, E832K/G, and T3033Lfs*29 were detected. Frameshift mutations in BRCA2 at N1784 (N1784Kfs*3, N1784Tfs*3) were frequently observed in both male and female patients. Compared with those in females, BRCA mutations in males were associated with decreased overall survival (OS) and progression-free survival (PFS). Male patients with deleterious BRCAm displayed increased OS compared with non-BRCAm carriers. The subgroup analysis demonstrated that BRCAm was associated with increased OS in gastric and bladder cancers, decreased PFS in prostate, esophageal, and head and neck cancers, and decreased OS in glioma/glioblastoma in males. CONCLUSION These findings provide an overview of the distinct characteristics and clinical outcomes of male patients with BRCA-associated tumors, suggesting the importance of further genetic BRCA testing in males.
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Affiliation(s)
- Peng Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060. .,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060. .,Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, P. R. China.
| | - Yue Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060.,Department of Molecular Diagnosis, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060
| | - Xue Chao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060.,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060
| | - Jibin Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060.,Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060
| | - Rongzhen Luo
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060.,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060
| | - Mei Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060.,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060
| | - Jiehua He
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China, 510060. .,Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China, 510060. .,Department of Pathology, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510080, Guangzhou, P. R. China.
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12
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Wokołorczyk D, Kluźniak W, Huzarski T, Gronwald J, Szymiczek A, Rusak B, Stempa K, Gliniewicz K, Kashyap A, Morawska S, Dębniak T, Jakubowska A, Szwiec M, Domagała P, Lubiński J, Narod SA, Akbari MR, Cybulski C. Mutations in ATM, NBN and BRCA2 predispose to aggressive prostate cancer in Poland. Int J Cancer 2020; 147:2793-2800. [PMID: 32875559 DOI: 10.1002/ijc.33272] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 01/04/2023]
Abstract
In designing national strategies for genetic testing, it is important to define the full spectrum of pathogenic mutations in prostate cancer (PCa) susceptibility genes. To investigate the frequency of mutations in PCa susceptibility genes in Polish familial PCa cases and to estimate gene-related PCa risks and probability of aggressive disease, we analyzed the coding regions of 14 genes by exome sequencing in 390 men with familial prostate cancer and 308 cancer-free controls. We compared the mutation frequencies between PCa cases and controls. We also compared clinical characteristics of prostate cancers between mutation carriers and noncarriers. Of the 390 PCa cases, 76 men (19.5%) carried a mutation in BRCA1, BRCA2, NBN, ATM, CHEK2, HOXB13, MSH2 or MSH6 genes. No mutations were found in BRIP1, PTEN, TP53, MLH1, PMS2 and SPOP. Significant associations with familial PCa risk were observed for CHEK2, NBN, ATM, and HOXB13. High-grade (Gleason 8-10) tumors were seen in 56% of BRCA2, NBN or ATM carriers, compared to 21% of patients who tested negative for mutations in these genes (OR = 4.7, 95% CI 2.0-10.7, P = .0003). In summary, approximately 20% of familial prostate cancer cases in Poland can be attributed to mutations in eight susceptibility genes. Carriers of mutations in BRCA2, NBN and ATM develop aggressive disease and may benefit from intensified screening and/or chemotherapy.
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Affiliation(s)
- Dominika Wokołorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Wojciech Kluźniak
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Tomasz Huzarski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland.,Department of Clinical Genetics and Pathology, University of Zielona Góra, Poland
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Agata Szymiczek
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada
| | - Bogna Rusak
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Klaudia Stempa
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Katarzyna Gliniewicz
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Aniruddh Kashyap
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Sylwia Morawska
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Tadeusz Dębniak
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Jakubowska
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland.,Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Marek Szwiec
- Clinics of Oncology, University Hospital in Zielona Góra, Zielona Góra, Poland
| | - Paweł Domagała
- Department of Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Steven A Narod
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mohammad R Akbari
- Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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13
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Giri VN, Knudsen KE, Kelly WK, Cheng HH, Cooney KA, Cookson MS, Dahut W, Weissman S, Soule HR, Petrylak DP, Dicker AP, AlDubayan SH, Toland AE, Pritchard CC, Pettaway CA, Daly MB, Mohler JL, Parsons JK, Carroll PR, Pilarski R, Blanco A, Woodson A, Rahm A, Taplin ME, Polascik TJ, Helfand BT, Hyatt C, Morgans AK, Feng F, Mullane M, Powers J, Concepcion R, Lin DW, Wender R, Mark JR, Costello A, Burnett AL, Sartor O, Isaacs WB, Xu J, Weitzel J, Andriole GL, Beltran H, Briganti A, Byrne L, Calvaresi A, Chandrasekar T, Chen DYT, Den RB, Dobi A, Crawford ED, Eastham J, Eggener S, Freedman ML, Garnick M, Gomella PT, Handley N, Hurwitz MD, Izes J, Karnes RJ, Lallas C, Languino L, Loeb S, Lopez AM, Loughlin KR, Lu-Yao G, Malkowicz SB, Mann M, Mille P, Miner MM, Morgan T, Moreno J, Mucci L, Myers RE, Nielsen SM, O’Neil B, Pinover W, Pinto P, Poage W, Raj GV, Rebbeck TR, Ryan C, Sandler H, Schiewer M, Scott EMD, Szymaniak B, Tester W, Trabulsi EJ, Vapiwala N, Yu EY, Zeigler-Johnson C, Gomella LG. Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019. J Clin Oncol 2020; 38:2798-2811. [PMID: 32516092 PMCID: PMC7430215 DOI: 10.1200/jco.20.00046] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Germline testing (GT) is a central feature of prostate cancer (PCA) treatment, management, and hereditary cancer assessment. Critical needs include optimized multigene testing strategies that incorporate evolving genetic data, consistency in GT indications and management, and alternate genetic evaluation models that address the rising demand for genetic services. METHODS A multidisciplinary consensus conference that included experts, stakeholders, and national organization leaders was convened in response to current practice challenges and to develop a genetic implementation framework. Evidence review informed questions using the modified Delphi model. The final framework included criteria with strong (> 75%) agreement (Recommend) or moderate (50% to 74%) agreement (Consider). RESULTS Large germline panels and somatic testing were recommended for metastatic PCA. Reflex testing-initial testing of priority genes followed by expanded testing-was suggested for multiple scenarios. Metastatic disease or family history suggestive of hereditary PCA was recommended for GT. Additional family history and pathologic criteria garnered moderate consensus. Priority genes to test for metastatic disease treatment included BRCA2, BRCA1, and mismatch repair genes, with broader testing, such as ATM, for clinical trial eligibility. BRCA2 was recommended for active surveillance discussions. Screening starting at age 40 years or 10 years before the youngest PCA diagnosis in a family was recommended for BRCA2 carriers, with consideration in HOXB13, BRCA1, ATM, and mismatch repair carriers. Collaborative (point-of-care) evaluation models between health care and genetic providers was endorsed to address the genetic counseling shortage. The genetic evaluation framework included optimal pretest informed consent, post-test discussion, cascade testing, and technology-based approaches. CONCLUSION This multidisciplinary, consensus-driven PCA genetic implementation framework provides novel guidance to clinicians and patients tailored to the precision era. Multiple research, education, and policy needs remain of importance.
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Affiliation(s)
- Veda N. Giri
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
- Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Karen E. Knudsen
- Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - William K. Kelly
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Heather H. Cheng
- Department of Medicine, University of Washington, and Fred Hutchinson Cancer Research Center, Division of Clinical Research, Seattle, WA
| | - Kathleen A. Cooney
- Duke University School of Medicine and Duke Cancer Institute, Durham, NC
| | | | - William Dahut
- Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | | | - Adam P. Dicker
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Amanda E. Toland
- Department of Cancer Biology and Genetics, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
| | - Colin C. Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | | | | | | | | | - Peter R. Carroll
- Department of Urology, University of California, San Francisco, San Francisco, CA
| | - Robert Pilarski
- James Comprehensive Cancer Center and Department of Internal Medicine, The Ohio State University, Columbus, OH
| | - Amie Blanco
- University of California, San Francisco, Cancer Genetics and Prevention Program, San Francisco, CA
| | - Ashley Woodson
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Alanna Rahm
- Center for Health Research, Genomic Medicine Institute, Geisinger, Danville, PA
| | | | | | | | - Colette Hyatt
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Felix Feng
- Departments of Radiation Oncology, Urology, and Medicine, University of California, San Francisco, San Francisco, CA
| | | | - Jacqueline Powers
- University of Pennsylvania, Basser Center for BRCA, Philadelphia, PA
| | | | | | | | - James Ryan Mark
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Anthony Costello
- Urology at Royal Melbourne Hospital, North Melbourne, VIC, Australia
| | | | | | | | - Jianfeng Xu
- North Shore University Health System, Evanston, IL
| | | | | | - Himisha Beltran
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Alberto Briganti
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Anne Calvaresi
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Thenappan Chandrasekar
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Robert B. Den
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Albert Dobi
- Henry Jackson Foundation for the Advancement of Military Medicine, Center for Prostate Disease Research, Department of Surgery, Uniformed Services University and the Walter Reed National Military Medical Center, Bethesda, MD
| | | | - James Eastham
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Marc Garnick
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Nathan Handley
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Mark D. Hurwitz
- Department of Radiation Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Joseph Izes
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Costas Lallas
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Lucia Languino
- Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY
| | - Ana Maria Lopez
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Grace Lu-Yao
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Mark Mann
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Patrick Mille
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | | | | | - Lorelei Mucci
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston MA
| | - Ronald E. Myers
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Brock O’Neil
- University of Utah, Huntsman Cancer Institute, Salt Lake City, UT
| | | | - Peter Pinto
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Wendy Poage
- Prostate Conditions Education Council, Elizabeth, CO
| | - Ganesh V. Raj
- University of Texas Southwestern Medical Center at Dallas, Dallas, TX
| | - Timothy R. Rebbeck
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston MA
| | - Charles Ryan
- University of Minnesota and Masonic Cancer Center, Madison, WI
| | | | - Matthew Schiewer
- Department of Cancer Biology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | | | - William Tester
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Edouard J. Trabulsi
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | | | - Evan Y. Yu
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Charnita Zeigler-Johnson
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Leonard G. Gomella
- Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
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14
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Stellato M, Guadalupi V, Sepe P, Mennitto A, Claps M, Zattarin E, Verzoni E, Valdagni R, De Braud FG, Santini D, Tonini G, Procopio G. The emerging role of PARP inhibitors in prostate cancer. Expert Rev Anticancer Ther 2020; 20:715-726. [PMID: 32758032 DOI: 10.1080/14737140.2020.1797497] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In prostate cancer , there has recently been an emerging interest in mutations in genes belonging to the homologous recombination repair (HRR) pathway and in the inhibition of poly (ADP-ribose) polymerase (PARP) proteins. AREAS COVERED Mutations in the HRR genes, including BRCA1, BRCA2, and Ataxia-Telangiesctasia mutated (ATM), have been reported in prostate cancer, with different incidence in the localized and advanced settings. The PARP enzyme complex is involved in repair of DNA damage and its inhibition causes the accumulation of DNA mutations in HRR deficient cells. Several PARP inhibitors (PARPi) are under development, such as olaparib, talazoparib, niraparib, rucaparib, and veliparib. In metastatic castration resistant prostate cancer (mCRPC), olaparib has been the most studied and its clinical efficacy has been validated in a phase III clinical trial. Rucaparib and niraparib have also shown promising results in the preliminary analyzes of two phase II trials, while talazoparib is currently under development. EXPERT OPINION PARPi have become part of the treatment of mCRPC. Early results of combination therapy with PARPi and new hormonal therapy are promising and are supported by a strong biological rationale. Current results need to be validated in randomized phase III-controlled trials in order to translate the use of PARPi into real world practice.
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Affiliation(s)
- Marco Stellato
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Valentina Guadalupi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Pierangela Sepe
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Alessia Mennitto
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Mélanie Claps
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Emma Zattarin
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Elena Verzoni
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy
| | - Riccardo Valdagni
- Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy.,Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milano, Italy.,Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milano, Italy
| | - Filippo Gm De Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Dei Tumori , Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan , Milan, Italy
| | - Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University of Rome , Rome, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University of Rome , Rome, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology, Campus Bio-Medico University of Rome , Rome, Italy
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15
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BRCA testing in a genomic diagnostics referral center during the COVID-19 pandemic. Mol Biol Rep 2020; 47:4857-4860. [PMID: 32388698 PMCID: PMC7210797 DOI: 10.1007/s11033-020-05479-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 12/22/2022]
Abstract
The first person-to-person transmission of the 2019-novel coronavirus in Italy on 21 February 2020 led to an infection chain that represents one of the largest known COVID-19 outbreaks outside Asia. Hospitals have been forced to reorganized their units in response to prepare for an unforeseen healthcare emergency. In this context, our laboratory (Molecular and Genomic Diagnostics Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS) re-modulated its priorities by temporarily interrupting most of the molecular tests guaranteeing only those considered “urgent” and not postponable. In particular, this paper details changes regarding the execution of germline BRCA (gBRCA) testing in our laboratory. A substantial reduction in gBRCA testing (about 60%) compared to the first 2 months of the current year was registered, but the requests have not been reset. The requesting physicians were mainly gynaecologists and oncologists. These evidences further emphasize the new era of gBRCA testing in the management of cancer patients and confirms definitively the integration of gBRCA testing/Next Generation Sequencing (NGS) into clinical oncology. Finally, a re-organization of gBRCA testing in our Unit, mainly related to delayed and reduced arrival of tests was necessary, ensuring, however, a high-quality standard and reliability, mandatory for gBRCA testing in a clinical setting.
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16
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Boyle JL, Hahn AW, Kapron AL, Kohlmann W, Greenberg SE, Parnell TJ, Teerlink CC, Maughan BL, Feng BJ, Cannon-Albright L, Agarwal N, Cooney KA. Pathogenic Germline DNA Repair Gene and HOXB13 Mutations in Men With Metastatic Prostate Cancer. JCO Precis Oncol 2020; 4:1900284. [PMID: 32923906 PMCID: PMC7446531 DOI: 10.1200/po.19.00284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2020] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Germline mutations in DNA repair (DR) genes and susceptibility genes CDKN2A and HOXB13 have previously been associated with prostate cancer (PC) incidence and/or progression. However, the role and prevalence of this class of mutations in metastatic PC (mPC) are not fully understood. PATIENTS AND METHODS To evaluate the frequency of pathogenic/likely pathogenic germline variants (PVs/LPVs) in men with mPC, this study sequenced 38 DR genes, CDKN2A, and HOXB13 in a predominantly white cohort of 317 patients with mPC. A PC registry at the University of Utah was used for patient sample acquisition and retrospective clinical data collection. Deep target sequencing allowed for germline and copy number variant analyses. Validated PVs/LPVs were integrated with clinical and demographic data for statistical correlation analyses. RESULTS All pathogenic variants were found in men self-reported as white, with a carrier frequency of 8.5% (DR genes, 7.3%; CDKN2A/HOXB13, 1.2%). Consistent with previous reports, mutations were most frequently identified in the breast cancer susceptibility gene BRCA2. It was also found that 50% of identified PVs/LPVs were categorized as founder mutations with European origins. Correlation analyses did not support a trend toward more advanced or earlier-onset disease in comparisons between carriers and noncarriers of deleterious DR or HOXB13 G84E mutations. CONCLUSION These findings demonstrate a lower prevalence of germline PVs/LPVs in an unselected, predominantly white mPC cohort than previously reported, which may have implications for the design of clinical trials testing targeted therapies. Larger studies in broad and diverse populations are needed to more accurately define the prevalence of germline mutations in men with mPC.
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Affiliation(s)
- Julie L Boyle
- Department of Internal Medicine, University of Utah, Salt Lake City, UT.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Andrew W Hahn
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Ashley L Kapron
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Wendy Kohlmann
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | | | | | - Craig C Teerlink
- Department of Internal Medicine, University of Utah, Salt Lake City, UT.,Department of Family and Preventative Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Benjamin L Maughan
- Department of Internal Medicine, University of Utah, Salt Lake City, UT.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Bing-Jian Feng
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.,Department of Dermatology, University of Utah, Salt Lake City, UT
| | - Lisa Cannon-Albright
- Department of Internal Medicine, University of Utah, Salt Lake City, UT.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.,George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
| | - Neeraj Agarwal
- Department of Internal Medicine, University of Utah, Salt Lake City, UT.,Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Kathleen A Cooney
- Department of Medicine and the Duke Cancer Institute, Duke University School of Medicine, Durham, NC
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Patel VL, Busch EL, Friebel TM, Cronin A, Leslie G, McGuffog L, Adlard J, Agata S, Agnarsson BA, Ahmed M, Aittomäki K, Alducci E, Andrulis IL, Arason A, Arnold N, Artioli G, Arver B, Auber B, Azzollini J, Balmaña J, Barkardottir RB, Barnes DR, Barroso A, Barrowdale D, Belotti M, Benitez J, Bertelsen B, Blok MJ, Bodrogi I, Bonadona V, Bonanni B, Bondavalli D, Boonen SE, Borde J, Borg A, Bradbury AR, Brady A, Brewer C, Brunet J, Buecher B, Buys SS, Cabezas-Camarero S, Caldés T, Caliebe A, Caligo MA, Calvello M, Campbell IG, Carnevali I, Carrasco E, Chan TL, Chu ATW, Chung WK, Claes KBM, Collaborators GS, Collaborators E, Cook J, Cortesi L, Couch FJ, Daly MB, Damante G, Darder E, Davidson R, de la Hoya M, Puppa LD, Dennis J, Díez O, Ding YC, Ditsch N, Domchek SM, Donaldson A, Dworniczak B, Easton DF, Eccles DM, Eeles RA, Ehrencrona H, Ejlertsen B, Engel C, Evans DG, Faivre L, Faust U, Feliubadaló L, Foretova L, Fostira F, Fountzilas G, Frost D, García-Barberán V, Garre P, Gauthier-Villars M, Géczi L, Gehrig A, Gerdes AM, Gesta P, Giannini G, Glendon G, Godwin AK, Goldgar DE, Greene MH, Gutierrez-Barrera AM, Hahnen E, Hamann U, Hauke J, Herold N, Hogervorst FBL, Honisch E, Hopper JL, Hulick PJ, Investigators KC, Investigators H, Izatt L, Jager A, James P, Janavicius R, Jensen UB, Jensen TD, Johannsson OT, John EM, Joseph V, Kang E, Kast K, Kiiski JI, Kim SW, Kim Z, Ko KP, Konstantopoulou I, Kramer G, Krogh L, Kruse TA, Kwong A, Larsen M, Lasset C, Lautrup C, Lazaro C, Lee J, Lee JW, Lee MH, Lemke J, Lesueur F, Liljegren A, Lindblom A, Llovet P, Lopez-Fernández A, Lopez-Perolio I, Lorca V, Loud JT, Ma ESK, Mai PL, Manoukian S, Mari V, Martin L, Matricardi L, Mebirouk N, Medici V, Meijers-Heijboer HEJ, Meindl A, Mensenkamp AR, Miller C, Gomes DM, Montagna M, Mooij TM, Moserle L, Mouret-Fourme E, Mulligan AM, Nathanson KL, Navratilova M, Nevanlinna H, Niederacher D, Nielsen FCC, Nikitina-Zake L, Offit K, Olah E, Olopade OI, Ong KR, Osorio A, Ott CE, Palli D, Park SK, Parsons MT, Pedersen IS, Peissel B, Peixoto A, Pérez-Segura P, Peterlongo P, Petersen AH, Porteous ME, Pujana MA, Radice P, Ramser J, Rantala J, Rashid MU, Rhiem K, Rizzolo P, Robson ME, Rookus MA, Rossing CM, Ruddy KJ, Santos C, Saule C, Scarpitta R, Schmutzler RK, Schuster H, Senter L, Seynaeve CM, Shah PD, Sharma P, Shin VY, Silvestri V, Simard J, Singer CF, Skytte AB, Snape K, Solano AR, Soucy P, Southey MC, Spurdle AB, Steele L, Steinemann D, Stoppa-Lyonnet D, Stradella A, Sunde L, Sutter C, Tan YY, Teixeira MR, Teo SH, Thomassen M, Tibiletti MG, Tischkowitz M, Tognazzo S, Toland AE, Tommasi S, Torres D, Toss A, Trainer AH, Tung N, van Asperen CJ, van der Baan FH, van der Kolk LE, van der Luijt RB, van Hest LP, Varesco L, Varon-Mateeva R, Viel A, Vierstraete J, Villa R, von Wachenfeldt A, Wagner P, Wang-Gohrke S, Wappenschmidt B, Weitzel JN, Wieme G, Yadav S, Yannoukakos D, Yoon SY, Zanzottera C, Zorn KK, D'Amico AV, Freedman ML, Pomerantz MM, Chenevix-Trench G, Antoniou AC, Neuhausen SL, Ottini L, Nielsen HR, Rebbeck TR. Association of Genomic Domains in BRCA1 and BRCA2 with Prostate Cancer Risk and Aggressiveness. Cancer Res 2020; 80:624-638. [PMID: 31723001 PMCID: PMC7553241 DOI: 10.1158/0008-5472.can-19-1840] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/15/2022]
Abstract
Pathogenic sequence variants (PSV) in BRCA1 or BRCA2 (BRCA1/2) are associated with increased risk and severity of prostate cancer. We evaluated whether PSVs in BRCA1/2 were associated with risk of overall prostate cancer or high grade (Gleason 8+) prostate cancer using an international sample of 65 BRCA1 and 171 BRCA2 male PSV carriers with prostate cancer, and 3,388 BRCA1 and 2,880 BRCA2 male PSV carriers without prostate cancer. PSVs in the 3' region of BRCA2 (c.7914+) were significantly associated with elevated risk of prostate cancer compared with reference bin c.1001-c.7913 [HR = 1.78; 95% confidence interval (CI), 1.25-2.52; P = 0.001], as well as elevated risk of Gleason 8+ prostate cancer (HR = 3.11; 95% CI, 1.63-5.95; P = 0.001). c.756-c.1000 was also associated with elevated prostate cancer risk (HR = 2.83; 95% CI, 1.71-4.68; P = 0.00004) and elevated risk of Gleason 8+ prostate cancer (HR = 4.95; 95% CI, 2.12-11.54; P = 0.0002). No genotype-phenotype associations were detected for PSVs in BRCA1. These results demonstrate that specific BRCA2 PSVs may be associated with elevated risk of developing aggressive prostate cancer. SIGNIFICANCE: Aggressive prostate cancer risk in BRCA2 mutation carriers may vary according to the specific BRCA2 mutation inherited by the at-risk individual.
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Affiliation(s)
- Vivek L Patel
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | - Evan L Busch
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Tara M Friebel
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Dana-Farber Cancer Institute. Boston, Massachusetts
| | - Angel Cronin
- Dana-Farber Cancer Institute. Boston, Massachusetts
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Julian Adlard
- Yorkshire Regional Genetics Service, Chapel Allerton Hospital, Leeds, United Kingdom
| | - Simona Agata
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Bjarni A Agnarsson
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- School of Medicine, University of Iceland, Reykjavik, Iceland
| | - Munaza Ahmed
- North East Thames Regional Genetics Service, Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Kristiina Aittomäki
- Department of Clinical Genetics, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Elisa Alducci
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Irene L Andrulis
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Adalgeir Arason
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- BMC (Biomedical Centre), Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Norbert Arnold
- Department of Gynaecology and Obstetrics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
| | - Grazia Artioli
- ULSS 3 Serenissima, U.O.C. Oncologia ed Ematologia Oncologica, Mirano, Venice, Italy
| | - Brita Arver
- Department of Oncology, Karolinska Institutet, Stockholm, Sweden
| | - Bernd Auber
- Institute of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Jacopo Azzollini
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Judith Balmaña
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Rosa B Barkardottir
- Department of Pathology, Landspitali University Hospital, 101, Reykjavik, Iceland
- BMC (Biomedical Centre), Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Daniel R Barnes
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Alicia Barroso
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Daniel Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | | | - Javier Benitez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Birgitte Bertelsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marinus J Blok
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Istvan Bodrogi
- Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary
| | - Valérie Bonadona
- Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Davide Bondavalli
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanne E Boonen
- Clinical Genetic Unit, Department of Paediatrics, Zealand University Hospital, Roskilde, Denmark
| | - Julika Borde
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Ake Borg
- Department of Oncology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Angela R Bradbury
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Angela Brady
- North West Thames Regional Genetics Service, Kennedy Galton Centre, The North West London Hospitals NHS Trust, Middlesex, United Kingdom
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon & Exeter Hospital, Exeter, United Kingdom
| | - Joan Brunet
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI (Institut d'Investigació Biomèdica de Girona), Catalan Institute of Oncology, CIBERONC, Girona, Spain
| | | | - Saundra S Buys
- Department of Medicine, Huntsman Cancer Institute, Salt Lake City, Utah
| | | | - Trinidad Caldés
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Almuth Caliebe
- Institute of Human Genetics, University Hospital of Schleswig-Holstein, Campus Kiel, Christian-Albrechts University Kiel, Kiel, Germany
| | - Maria A Caligo
- Section of Molecular Genetics, Department of Laboratory Medicine, University Hospital of Pisa, Pisa, Italy
| | - Mariarosaria Calvello
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ian G Campbell
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ileana Carnevali
- UO Anatomia Patologica, Ospedale di Circolo-Università dell'Insubria, Varese, Italy
| | - Estela Carrasco
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Tsun L Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Pathology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Annie T W Chu
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, New York
| | | | | | - Embrace Collaborators
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, United Kingdom
| | - Laura Cortesi
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Mary B Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Giuseppe Damante
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Esther Darder
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBGI (Institut d'Investigació Biomèdica de Girona), Catalan Institute of Oncology, CIBERONC, Girona, Spain
| | - Rosemarie Davidson
- Department of Clinical Genetics, South Glasgow University Hospitals, Glasgow, United Kingdom
| | - Miguel de la Hoya
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Lara Della Puppa
- Division of Functional Onco-genomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Orland Díez
- Oncogenetics Group, Clinical and Molecular Genetics Area, Vall d'Hebron Institute of Oncology (VHIO), University Hospital, Barcelona, Spain
| | - Yuan Chun Ding
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Nina Ditsch
- Department of Gynecology and Obstetrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Susan M Domchek
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alan Donaldson
- Clinical Genetics Department, St Michael's Hospital, Bristol, United Kingdom
| | - Bernd Dworniczak
- Institute of Human Genetics, University of Münster, Münster, Germany
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, United Kingdom
| | - Diana M Eccles
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Rosalind A Eeles
- Oncogenetics Team, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, United Kingdom
| | - Hans Ehrencrona
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden
| | - Bent Ejlertsen
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- LIFE - Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - D Gareth Evans
- Division of Evolution and Genomic Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health and Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Laurence Faivre
- Unité d'oncogénétique, Centre de Lutte Contre le Cancer, Centre Georges-François Leclerc, Dijon, France
| | - Ulrike Faust
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Lídia Feliubadaló
- Molecular Diagnostic Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - George Fountzilas
- Second Department of Medical Oncology, EUROMEDICA General Clinic of Thessaloniki, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Debra Frost
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Vanesa García-Barberán
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Pilar Garre
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | | | - Lajos Géczi
- Department of Chemotherapy, National Institute of Oncology, Budapest, Hungary
| | - Andrea Gehrig
- Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Anne-Marie Gerdes
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - Paul Gesta
- Service Régional Oncogénétique Poitou-Charentes, CH Niort, Niort, France
| | - Giuseppe Giannini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Gord Glendon
- Fred A. Litwin Center for Cancer Genetics, Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Andrew K Godwin
- Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, Kansas
| | - David E Goldgar
- Department of Dermatology, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah
| | - Mark H Greene
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Angelica M Gutierrez-Barrera
- Department of Breast Medical Oncology and Clinical Genetics Program, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Eric Hahnen
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Hauke
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Natalie Herold
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Frans B L Hogervorst
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ellen Honisch
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Hulick
- Center for Medical Genetics, NorthShore University HealthSystem, Evanston, Illinois
- The University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - KConFab Investigators
- Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hebon Investigators
- The Hereditary Breast and Ovarian Cancer Research Group Netherlands (HEBON), Coordinating center: The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Agnes Jager
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Paul James
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Ramunas Janavicius
- Hematology, Oncology and Transfusion Medicine Center, Department of Molecular and Regenerative Medicine, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - Uffe Birk Jensen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | | | | | - Esther M John
- Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Vijai Joseph
- Clinical Genetics Research Lab, Department of Cancer Biology and Genetics, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Eunyoung Kang
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Karin Kast
- Department of Gynecology and Obstetrics, Technical University of Dresden, Dresden, Germany
| | - Johanna I Kiiski
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sung-Won Kim
- Department of Surgery, Daerim Saint Mary's Hospital, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Kwang-Pil Ko
- Department of Preventive Medicine, Gacheon University College of Medicine, Incheon, Republic of Korea
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Gero Kramer
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Lotte Krogh
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Torben A Kruse
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Surgery, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Department of Surgery, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Mirjam Larsen
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Christine Lasset
- Unité de Prévention et d'Epidémiologie Génétique, Centre Léon Bérard, Lyon, France
| | - Charlotte Lautrup
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
| | - Conxi Lazaro
- Molecular Diagnostic Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Jihyoun Lee
- Department of Surgery, Soonchunhyang University College of Medicine and Soonchunhyang University Hospital, Seoul, Korea
| | - Jong Won Lee
- Department of Surgery, Ulsan University College of Medicine and Asan Medical Center, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University College of Medicine and Soonchunhyang University Hospital, Seoul, Korea
| | - Johannes Lemke
- Institute of Human Genetics, University Hospital Leipzig, Leipzig, Germany
| | - Fabienne Lesueur
- Service de Génétique, Institut Curie, Paris, France
- Genetic Epidemiology of Cancer Team, Inserm U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | | | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Patricia Llovet
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Adria Lopez-Fernández
- High Risk and Cancer Prevention Group, Vall d'Hebron Institute of Oncology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Irene Lopez-Perolio
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Victor Lorca
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Jennifer T Loud
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Edmond S K Ma
- Hong Kong Hereditary Breast Cancer Family Registry, Cancer Genetics Centre, Happy Valley, Hong Kong
- Department of Pathology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | - Phuong L Mai
- Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Veronique Mari
- Département d'Hématologie-Oncologie Médicale, Centre Antoine Lacassagne, Nice, France
| | - Lynn Martin
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Laura Matricardi
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Noura Mebirouk
- Service de Génétique, Institut Curie, Paris, France
- Genetic Epidemiology of Cancer Team, Inserm U900, Paris, France
- Institut Curie, Paris, France
- Mines ParisTech, Fontainebleau, France
| | - Veronica Medici
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alfons Meindl
- Department of Gynecology and Obstetrics, Ludwig Maximilian University of Munich, Munich, Germany
| | - Arjen R Mensenkamp
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Clare Miller
- Department of Clinical Genetics, Alder Hey Hospital, Liverpool, United Kingdom
| | - Denise Molina Gomes
- Service de Biologie de la Reproduction, Cytogénétique et Génétique Médicale, CHI Poissy - Saint Germain, Poissy, France
| | - Marco Montagna
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Thea M Mooij
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Lidia Moserle
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada
| | - Katherine L Nathanson
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Dieter Niederacher
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Finn C Cilius Nielsen
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Kenneth Offit
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Edith Olah
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | | | - Kai-Ren Ong
- West Midlands Regional Genetics Service, Birmingham Women's Hospital Healthcare NHS Trust, Birmingham, United Kingdom
| | - Ana Osorio
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biomedical Network on Rare Diseases (CIBERER), Madrid, Spain
| | - Claus-Eric Ott
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Inge Sokilde Pedersen
- Section of Molecular Diagnostics, Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
| | - Bernard Peissel
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Ana Peixoto
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - Pedro Pérez-Segura
- Department of Oncology, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM - the FIRC (Italian Foundation for Cancer Research) Institute of Molecular Oncology, Milan, Italy
| | | | - Mary E Porteous
- South East of Scotland Regional Genetics Service, Western General Hospital, Edinburgh, United Kingdom
| | - Miguel Angel Pujana
- Translational Research Laboratory, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, in Fondazione IRCCS (Istituto Di Ricovero e Cura a Carattere Scientifico) Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Juliane Ramser
- Division of Gynaecology and Obstetrics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | | | - Muhammad U Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Basic Sciences, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - Kerstin Rhiem
- Center for Integrated Oncology (CIO), University Hospital of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Piera Rizzolo
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | - Mark E Robson
- Clinical Genetics Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Matti A Rookus
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Caroline M Rossing
- Center for Genomic Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Catarina Santos
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - Claire Saule
- Service de Génétique, Institut Curie, Paris, France
| | - Rosa Scarpitta
- Section of Genetic Oncology, Department of Laboratory Medicine, University and University Hospital of Pisa, Pisa, Italy
| | - Rita K Schmutzler
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Hélène Schuster
- Unité d'Oncogénétique, Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France
| | - Leigha Senter
- Clinical Cancer Genetics Program, Division of Human Genetics, Department of Internal Medicine, The Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Caroline M Seynaeve
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Payal D Shah
- Department of Medicine, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Priyanka Sharma
- Department of Internal Medicine, Division of Oncology, University of Kansas Medical Center, Westwood, Kansas
| | - Vivian Y Shin
- Department of Surgery, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Jacques Simard
- Genomics Center, Centre Hospitalier Universitaire de Québec - Université Laval, Research Centre, Québec City, Québec, Canada
| | - Christian F Singer
- Dept of OB/GYN and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | | | - Katie Snape
- Medical Genetics Unit, St George's, University of London, London, United Kingdom
| | - Angela R Solano
- INBIOMED, Faculty of Medicine/CONICET and CEMIC, Department of Clinical Chemistry, Medical Direction, University of Buenos Aires, Buenos Aires, Argentina
| | - Penny Soucy
- Department of Internal Medicine, Division of Oncology, University of Kansas Medical Center, Westwood, Kansas
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Amanda B Spurdle
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Linda Steele
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Doris Steinemann
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | - Dominique Stoppa-Lyonnet
- Service de Génétique, Institut Curie, Paris, France
- Department of Tumour Biology, INSERM U830, Paris, France
- Université Paris Descartes, Paris, France
| | - Agostina Stradella
- Genetic Counseling Unit, Hereditary Cancer Program, IDIBELL (Bellvitge Biomedical Research Institute), Catalan Institute of Oncology, CIBERONC, Barcelona, Spain
| | - Lone Sunde
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Yen Y Tan
- Department of OB/GYN, Medical University of Vienna, Vienna, Austria
| | - Manuel R Teixeira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
- Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
| | - Soo Hwang Teo
- Cancer Research Malaysia, Subang Jaya, Selangor, Malaysia
- Breast Cancer Research Unit, Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Mads Thomassen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | | | - Marc Tischkowitz
- Program in Cancer Genetics, Departments of Human Genetics and Oncology, McGill University, Montréal, Quebec, Canada
- Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Silvia Tognazzo
- Immunology and Molecular Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Amanda E Toland
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, Ohio
| | | | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Angela Toss
- Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alison H Trainer
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Center, Melbourne, Victoria, Australia
| | - Nadine Tung
- Department of Medical Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Christi J van Asperen
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Lizet E van der Kolk
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Rob B van der Luijt
- Department of Medical Genetics, University Medical Center, Utrecht, the Netherlands
| | - Liselotte P van Hest
- Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Liliana Varesco
- Unit of Hereditary Cancer, Department of Epidemiology, Prevention and Special Functions, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) AOU San Martino, IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy
| | - Raymonda Varon-Mateeva
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alessandra Viel
- Division of Functional Onco-genomics and Genetics, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Roberta Villa
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | - Philipp Wagner
- Department of Women's Health, Tubingen University Hospital, Tubingen, Germany
| | - Shan Wang-Gohrke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Barbara Wappenschmidt
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center for Hereditary Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | | | - Greet Wieme
- Centre for Medical Genetics, Ghent University, Ghent, Belgium
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Sook-Yee Yoon
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Cristina Zanzottera
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Kristin K Zorn
- Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Anthony V D'Amico
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
| | | | | | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Antonis C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, California
| | - Laura Ottini
- Department of Molecular Medicine, University La Sapienza, Rome, Italy
| | | | - Timothy R Rebbeck
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
- Dana-Farber Cancer Institute. Boston, Massachusetts
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Page EC, Bancroft EK, Brook MN, Assel M, Hassan Al Battat M, Thomas S, Taylor N, Chamberlain A, Pope J, Raghallaigh HN, Evans DG, Rothwell J, Maehle L, Grindedal EM, James P, Mascarenhas L, McKinley J, Side L, Thomas T, van Asperen C, Vasen H, Kiemeney LA, Ringelberg J, Jensen TD, Osther PJS, Helfand BT, Genova E, Oldenburg RA, Cybulski C, Wokolorczyk D, Ong KR, Huber C, Lam J, Taylor L, Salinas M, Feliubadaló L, Oosterwijk JC, van Zelst-Stams W, Cook J, Rosario DJ, Domchek S, Powers J, Buys S, O'Toole K, Ausems MGEM, Schmutzler RK, Rhiem K, Izatt L, Tripathi V, Teixeira MR, Cardoso M, Foulkes WD, Aprikian A, van Randeraad H, Davidson R, Longmuir M, Ruijs MWG, Helderman van den Enden ATJM, Adank M, Williams R, Andrews L, Murphy DG, Halliday D, Walker L, Liljegren A, Carlsson S, Azzabi A, Jobson I, Morton C, Shackleton K, Snape K, Hanson H, Harris M, Tischkowitz M, Taylor A, Kirk J, Susman R, Chen-Shtoyerman R, Spigelman A, Pachter N, Ahmed M, Ramon Y Cajal T, Zgajnar J, Brewer C, Gadea N, Brady AF, van Os T, Gallagher D, Johannsson O, Donaldson A, Barwell J, Nicolai N, Friedman E, Obeid E, Greenhalgh L, Murthy V, Copakova L, Saya S, McGrath J, Cooke P, Rønlund K, Richardson K, Henderson A, Teo SH, Arun B, Kast K, Dias A, Aaronson NK, Ardern-Jones A, Bangma CH, Castro E, Dearnaley D, Eccles DM, Tricker K, Eyfjord J, Falconer A, Foster C, Gronberg H, Hamdy FC, Stefansdottir V, Khoo V, Lindeman GJ, Lubinski J, Axcrona K, Mikropoulos C, Mitra A, Moynihan C, Rennert G, Suri M, Wilson P, Dudderidge T, Offman J, Kote-Jarai Z, Vickers A, Lilja H, Eeles RA. Interim Results from the IMPACT Study: Evidence for Prostate-specific Antigen Screening in BRCA2 Mutation Carriers. Eur Urol 2019; 76:831-842. [PMID: 31537406 PMCID: PMC6880781 DOI: 10.1016/j.eururo.2019.08.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/12/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Mutations in BRCA2 cause a higher risk of early-onset aggressive prostate cancer (PrCa). The IMPACT study is evaluating targeted PrCa screening using prostate-specific-antigen (PSA) in men with germline BRCA1/2 mutations. OBJECTIVE To report the utility of PSA screening, PrCa incidence, positive predictive value of PSA, biopsy, and tumour characteristics after 3 yr of screening, by BRCA status. DESIGN, SETTING, AND PARTICIPANTS Men aged 40-69 yr with a germline pathogenic BRCA1/2 mutation and male controls testing negative for a familial BRCA1/2 mutation were recruited. Participants underwent PSA screening for 3 yr, and if PSA > 3.0 ng/ml, men were offered prostate biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS PSA levels, PrCa incidence, and tumour characteristics were evaluated. Statistical analyses included Poisson regression offset by person-year follow-up, chi-square tests for proportion t tests for means, and Kruskal-Wallis for medians. RESULTS AND LIMITATIONS A total of 3027 patients (2932 unique individuals) were recruited (919 BRCA1 carriers, 709 BRCA1 noncarriers, 902 BRCA2 carriers, and 497 BRCA2 noncarriers). After 3 yr of screening, 527 men had PSA > 3.0 ng/ml, 357 biopsies were performed, and 112 PrCa cases were diagnosed (31 BRCA1 carriers, 19 BRCA1 noncarriers, 47 BRCA2 carriers, and 15 BRCA2 noncarriers). Higher compliance with biopsy was observed in BRCA2 carriers compared with noncarriers (73% vs 60%). Cancer incidence rate per 1000 person years was higher in BRCA2 carriers than in noncarriers (19.4 vs 12.0; p = 0.03); BRCA2 carriers were diagnosed at a younger age (61 vs 64 yr; p = 0.04) and were more likely to have clinically significant disease than BRCA2 noncarriers (77% vs 40%; p = 0.01). No differences in age or tumour characteristics were detected between BRCA1 carriers and BRCA1 noncarriers. The 4 kallikrein marker model discriminated better (area under the curve [AUC] = 0.73) for clinically significant cancer at biopsy than PSA alone (AUC = 0.65). CONCLUSIONS After 3 yr of screening, compared with noncarriers, BRCA2 mutation carriers were associated with a higher incidence of PrCa, younger age of diagnosis, and clinically significant tumours. Therefore, systematic PSA screening is indicated for men with a BRCA2 mutation. Further follow-up is required to assess the role of screening in BRCA1 mutation carriers. PATIENT SUMMARY We demonstrate that after 3 yr of prostate-specific antigen (PSA) testing, we detect more serious prostate cancers in men with BRCA2 mutations than in those without these mutations. We recommend that male BRCA2 carriers are offered systematic PSA screening.
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Affiliation(s)
| | - Elizabeth K Bancroft
- Oncogenetics Team, Institute of Cancer Research, London, UK; Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Mark N Brook
- Oncogenetics Team, Institute of Cancer Research, London, UK
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, USA
| | | | - Sarah Thomas
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Natalie Taylor
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jennifer Pope
- Oncogenetics Team, Institute of Cancer Research, London, UK
| | | | - D Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Jeanette Rothwell
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Lovise Maehle
- Department of medical genetics, Oslo University Hospital, 0424 Oslo, Norway
| | | | - Paul James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia; Genetic Medicine, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Lyon Mascarenhas
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Joanne McKinley
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lucy Side
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Tessy Thomas
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | | | - Hans Vasen
- The Foundation for the Detection of Hereditary Cancer, Leiden, The Netherlands
| | | | - Janneke Ringelberg
- The Foundation for the Detection of Hereditary Cancer, Leiden, The Netherlands
| | | | | | - Brian T Helfand
- John and Carol Walter Center for Urological Health, Division of Urology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Elena Genova
- John and Carol Walter Center for Urological Health, Division of Urology, NorthShore University HealthSystem, Evanston, IL, USA
| | - Rogier A Oldenburg
- Department of clinical genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Kai-Ren Ong
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham, UK
| | - Camilla Huber
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham, UK
| | - Jimmy Lam
- Department of Urology, Flinders Medical Centre, Bedford Park, SA, Australia
| | - Louise Taylor
- Department of Urology, Repatriation General Hospital, Daw Park, SA, Australia
| | - Monica Salinas
- Hereditary Cancer Program, ICO-IDIBELL (Bellvitge Biomedical Research Institute, Catalan Institute of Oncology), CIBERONC, Barcelona, Spain
| | - Lidia Feliubadaló
- Hereditary Cancer Program, ICO-IDIBELL (Bellvitge Biomedical Research Institute, Catalan Institute of Oncology), CIBERONC, Barcelona, Spain
| | - Jan C Oosterwijk
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | | | - Susan Domchek
- Basser Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacquelyn Powers
- Basser Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Saundra Buys
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Karen O'Toole
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Margreet G E M Ausems
- Division of Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Centre, Utrecht, The Netherlands
| | - Rita K Schmutzler
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kerstin Rhiem
- Center for Familial Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Louise Izatt
- Clinical Genetics Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Vishakha Tripathi
- Clinical Genetics Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Manuel R Teixeira
- Genetics Department and Research Center, Portuguese Oncology Institute (IPO Porto), Porto, Portugal; Biomedical Sciences Institute (ICBAS), Porto University, Porto, Portugal
| | - Marta Cardoso
- Genetics Department and Research Center, Portuguese Oncology Institute (IPO Porto), Porto, Portugal
| | - William D Foulkes
- Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada; Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Armen Aprikian
- Cancer Research Program, Research Institute of McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Rosemarie Davidson
- West of Scotland Genetic Service, Queen Elizabeth University Hospital, Glasgow, UK
| | - Mark Longmuir
- West of Scotland Genetic Service, Queen Elizabeth University Hospital, Glasgow, UK
| | | | | | - Muriel Adank
- VU University Medical Center, Amsterdam, The Netherlands
| | - Rachel Williams
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia; Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Lesley Andrews
- Hereditary Cancer Centre, Prince of Wales Hospital, Randwick, NSW, Australia; Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Declan G Murphy
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Dorothy Halliday
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Lisa Walker
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Annelie Liljegren
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Stefan Carlsson
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Ashraf Azzabi
- Northern Genetics Service, Newcastle upon Tyne Hospitals, UK
| | - Irene Jobson
- Northern Genetics Service, Newcastle upon Tyne Hospitals, UK
| | - Catherine Morton
- Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC, Australia
| | - Kylie Shackleton
- Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC, Australia
| | | | | | - Marion Harris
- Familial Cancer Centre, Monash Health, Clayton, VIC, Australia
| | - Marc Tischkowitz
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Trust, Cambridge, UK; Academic Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Level 6 Addenbrooke's Treatment Centre, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
| | - Amy Taylor
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Judy Kirk
- Familial Cancer Service, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Sydney, NSW, Australia
| | - Rachel Susman
- Genetic Health Queensland, Royal Brisbane & Women's Hospital, Herston, QLD, Australia
| | | | - Allan Spigelman
- Hunter Family Cancer Service, Waratah, NSW, Australia; University of New South Wales, St Vincent's Clinical School, NSW, Australia; Cancer Genetics Clinic, The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW, Australia
| | - Nicholas Pachter
- Genetic Services of WA, King Edward Memorial Hospital, Subiaco, WA, Australia; Department of Paediatrics, University of Western Australia, Perth, WA, Australia
| | - Munaza Ahmed
- NE Thames Regional Genetics Service, Institute of Child Health, London, UK
| | | | | | - Carole Brewer
- Peninsular Genetics, Derriford Hospital, Plymouth, UK; Royal Devon and Exeter Hospital, Exeter, UK
| | - Neus Gadea
- Hospital Vall d'Hebron, Barcelona, Spain
| | - Angela F Brady
- North West Thames Regional Genetics Service, Kennedy-Galton Centre, London North West University Healthcare NHS Trust, Harrow, UK
| | - Theo van Os
- Academic Medical Center, Amsterdam, The Netherlands
| | | | - Oskar Johannsson
- Landspitali-the National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Julian Barwell
- University of Leicester, Leicester, UK; University Hospitals Leicester, Leicester, UK
| | | | | | - Elias Obeid
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Lynn Greenhalgh
- Clinical Genetics Service, Liverpool Women's Hospital, Liverpool, UK
| | | | | | - Sibel Saya
- Oncogenetics Team, Institute of Cancer Research, London, UK
| | - John McGrath
- Royal Devon and Exeter Hospital, Exeter, UK; University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | | | - Karina Rønlund
- Department of Clinical Genetics, Vejle Hospital, Vejle, Denmark
| | - Kate Richardson
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Alex Henderson
- Northern Genetics Service, Newcastle upon Tyne Hospitals, UK; West Cumberland Infirmary, Whitehaven, UK
| | - Soo H Teo
- Cancer Research Initiatives Foundation, Subang Jaya Medical Centre, Selangor, Darul Ehsan, Malaysia
| | - Banu Arun
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Karin Kast
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Alexander Dias
- Oncogenetics Team, Institute of Cancer Research, London, UK; Instituto Nacional de Cancer Jose de Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | | | - Audrey Ardern-Jones
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Chris H Bangma
- Department of urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elena Castro
- Spanish National Cancer Research Center, Madrid, Spain
| | - David Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, Sutton, UK
| | - Diana M Eccles
- The University of Southampton Medical School, Southampton, UK; Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Karen Tricker
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Jorunn Eyfjord
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Freddie C Hamdy
- Churchill Hospital, Headington, Oxford, UK; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | | | - Vincent Khoo
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK; St George's Hospital, Tooting, London, UK; Division of Radiotherapy and Imaging, The Institute of Cancer Research, Sutton, UK; Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | - Geoffrey J Lindeman
- Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC, Australia; Department of Medicine, The University of Melbourne, Parkville, VIC, Australia; Cancer Biology and Stem Cells Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Karol Axcrona
- Department of Urology, Akershus University Hospital, Lørenskog, Norway
| | | | - Anita Mitra
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Clare Moynihan
- Oncogenetics Team, Institute of Cancer Research, London, UK
| | - Gadi Rennert
- CHS National Cancer Control Center, Carmel Medical Center, Haifa, Israel
| | | | | | | | - Judith Offman
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, Guy's Cancer Centre, Guy's Hospital, London, UK
| | | | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Hans Lilja
- Department of Translational Medicine, Lund University, Malmö, Sweden; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Departments of Laboratory Medicine, Surgery, and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Rosalind A Eeles
- Oncogenetics Team, Institute of Cancer Research, London, UK; Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
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19
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Lang SH, Swift SL, White H, Misso K, Kleijnen J, Quek RG. A systematic review of the prevalence of DNA damage response gene mutations in prostate cancer. Int J Oncol 2019; 55:597-616. [PMID: 31322208 PMCID: PMC6685596 DOI: 10.3892/ijo.2019.4842] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 06/28/2019] [Indexed: 02/06/2023] Open
Abstract
Several ongoing international prostate cancer (PC) clinical trials are exploring therapies that target the DNA damage response (DDR) pathway. This systematic review summarizes the prevalence of DDR mutation carriers in the unselected (general) PC and familial PC populations. A total of 11 electronic databases, 10 conference proceedings, and grey literature sources were searched from their inception to December 2017. Studies reporting the prevalence of somatic and/or germline DDR mutations were summarized. Metastatic PC (mPC), castration‑resistant PC (CRPC) and metastatic CRPC (mCRPC) subgroups were included. A total of 11,648 records were retrieved, and 80 studies (103 records) across all PC populations were included; 59 records were of unselected PC and 13 records of familial PC. Most data were available for DDR panels (n=12 studies), ataxia telangiectasia mutated (ATM; n=13), breast cancer susceptibility gene (BRCA)1 (n=14) and BRCA2 (n=20). ATM, BRCA2 and partner and localizer of BRCA2 (PALB2) had the highest mutation rates (≥4%). Median prevalence rates for DDR germline mutations were 18.6% in PC (range, 17.2‑19%; three studies, n=1,712), 11.6% in mPC (range, 11.4‑11.8%; two studies, n=1,261) and 8.3% in mCRPC (range, 7.5‑9.1%; two studies, n=738). Median prevalence rates for DDR somatic mutations were 10.7% in PC (range, 4.9‑22%; three studies, n=680), 13.2% in mPC (range, 10‑16.4%; two studies, n=105) and not reported (NR) in mCRPC. The prevalence of DDR germline and/or somatic mutations was 27% in PC (one study, n=221), 22.67% in mCRPC (one study, n=150) and NR in mPC. In familial PC, median mutation prevalence was 12.1% (range, 7.3‑16.9%) for germline DDR (two studies, n=315) and 3.7% (range, 1.3‑7.9%) for BRCA2 (six studies, n=945). In total, 88% of studies were at a high risk of bias. The prevalence of DDR gene mutations in PC varied widely within somatic subgroups depending on study size, genetic screening techniques, DDR mutation definition and PC diagnosis; somatic and/or germline DDR mutation prevalence was in the range of 23‑27% in PC. These findings support DDR mutation testing for all patients with PC (including those with mCRPC). With the advent of the latest clinical practice PC guidelines highlighting the importance of DDR mutation screening, and ongoing mCRPC clinical trials evaluating DDR mutation‑targeted drugs, future larger epidemiological studies are warranted to further quantify the international burden of DDR mutations in PC.
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Affiliation(s)
| | | | | | - Kate Misso
- Information Department, Kleijnen Systematic Reviews Ltd., Escrick, York YO19 6FD, UK
| | - Jos Kleijnen
- Reviews Department
- School for Public Health and Primary Care, Maastricht University, Maastricht, 6200 MD, The Netherlands
| | - Ruben G.W. Quek
- Health Economics and Outcomes Research, Pfizer Inc., San Francisco, CA 94105, USA
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20
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Oh M, Alkhushaym N, Fallatah S, Althagafi A, Aljadeed R, Alsowaida Y, Jeter J, Martin JR, Babiker HM, McBride A, Abraham I. The association of BRCA1 and BRCA2 mutations with prostate cancer risk, frequency, and mortality: A meta-analysis. Prostate 2019; 79:880-895. [PMID: 30900310 DOI: 10.1002/pros.23795] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/20/2019] [Accepted: 02/27/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND A prior meta-analysis found no association between BRCA1 mutation and prostate cancer (PCa). Subsequent BRCA2 mutation studies have shown an association with PCa risk and mortality. We conducted a meta-analysis of overall BRCA mutation carriers and in subgroups to (1) estimate PCa risk in BRCA mutation carriers, (2) evaluate the frequency of BRCA mutation carriers in patients with PCa, and (3) compare cancer-specific survival (CSS) and overall survival (OS) among BRCA mutation carriers and noncarriers. METHODS We searched the PubMed/MEDLINE, Embase, and Cochrane databases. Unadjusted odds ratio (OR), percentage (%), and hazard ratio (HR) were used to calculate pooled estimates for PCa risk, frequency, and survival, respectively. Subgroup analyses by mutation type ( BRCA1 or BRCA2) were conducted for the three objectives. Further subgroup analyses by study design (age-sex-adjusted or crude), ascertainment method (ascertained or inferred genotyping), population (Ashkenazi Jewish or general population), and survival outcomes (CSS or OS) were conducted. The associations were evaluated using random-effects models, in two-sided statistical tests. RESULTS A total of 8 cohort, 7 case-control, 4 case-series, 28 frequency, and 11 survival studies were included. Being a BRCA mutation carrier ( BRCA1 and/or BRCA2) was associated with a significant increase in PCa risk (OR = 1.90, 95% CI = 1.58-2.29), with BRCA2 mutation being associated with a greater risk of PCa (OR = 2.64, 95% CI = 2.03-3.47) than BRCA1 (OR = 1.35, 95% CI = 1.03-1.76). The frequency of BRCA1 and BRCA2 carriers in patients with PCa was 0.9% and 2.2%, respectively. OS (HR = 2.21, 95% CI = 1.64-2.30) and CSS (HR = 2.63, 95% CI = 2.00-3.45) were significantly worse among BRCA2 carriers compared to noncarriers, whereas OS (HR = 0.47, 95% CI = 0.11-1.99) and CSS (HR = 1.07, 95% CI = 0.38-2.96) were statistically not significant when comparing BRCA1 carriers and noncarriers. CONCLUSIONS There is a 1.90-fold greater risk of PCa in overall BRCA mutation carriers. This elevated PCa risk is attributable mainly to a 2.64-fold greater risk of PCa in BRCA2 carriers compared to a moderate 1.35-fold greater risk in BRCA1 carriers. The frequency of BRCA2 mutations was higher than BRCA1 mutations among patients with PCa. BRCA2 but not BRCA1 mutations were associated with higher PCa mortality. The BRCA mutation may be a clinical factor to stratify high-risk patients and guide clinical strategies for more effective treatments for patients with PCa.
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Affiliation(s)
- Mok Oh
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
| | - Nasser Alkhushaym
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Clinical Pharmacy, Royal Commission Health Services Program, Jubail, Saudi Arabia
| | - Saad Fallatah
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Medina, Saudi Arabia
| | - Abdulhamid Althagafi
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rana Aljadeed
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Pharmacy, Houston Methodist Hospital, Houston, Texas
| | - Yazed Alsowaida
- Department of Pharmacy Practice & Science, Center for Health Outcomes and PharmacoEconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia
| | - Joanne Jeter
- Departments of Human Genetics and Medical Oncology, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Jennifer R Martin
- Department of Pharmacy Practice and Science, College of Pharmacy, Arizona Health Sciences Library, University of Arizona, Tucson, Arizona
| | - Hani M Babiker
- Department of Hematology & Oncology, College of Medicine, Banner University Medical Center, University of Arizona Cancer Center, Tucson, Arizona
- Department of Pharmacy Practice and Science, College of Pharmacy, Banner University Medical Center, University of Arizona Cancer Center, Tucson, Arizona
| | - Ali McBride
- Department of Pharmacy Practice and Science, College of Pharmacy, Banner University Medical Center, University of Arizona Cancer Center, Tucson, Arizona
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona
| | - Ivo Abraham
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
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21
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Pilarski R. The Role of BRCA Testing in Hereditary Pancreatic and Prostate Cancer Families. Am Soc Clin Oncol Educ Book 2019; 39:79-86. [PMID: 31099688 DOI: 10.1200/edbk_238977] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Beyond breast and ovarian cancers, mutations in the BRCA1 and BRCA2 genes increase risks for pancreatic and prostate cancers and contribute to the prevalence of these cancers. Mutations in a number of other genes have also been shown to increase the risk for these cancers as well. Genetic testing is playing an increasingly important role in the treatment of patients with pancreatic and prostate cancer and is now recommended for all patients with pancreatic or metastatic prostate cancer, as well as patients with high Gleason grade prostate cancer and a remarkable family history. Identification of an inherited mutation can direct evaluation of the patient for other cancer risks as well as identification and management of disease in at-risk relatives. Growing evidence suggests improved responses to PARP inhibitors and other therapies in patients with mutations in the BRCA and other DNA repair genes. Although more work must be done to clarify the prevalence and penetrance of mutations in genes other than BRCA1 and BRCA2 in patients with pancreatic and prostate cancer, in most cases, testing is now being done with a panel of multiple genes. Because of the complexities in panel testing and the increased likelihood of finding variants of uncertain significance, pre- and post-test genetic counseling are essential.
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Affiliation(s)
- Robert Pilarski
- 1 Division of Human Genetics and Comprehensive Cancer Center, The Ohio State University, Columbus, OH
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22
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Mikropoulos C, Selkirk CGH, Saya S, Bancroft E, Vertosick E, Dadaev T, Brendler C, Page E, Dias A, Evans DG, Rothwell J, Maehle L, Axcrona K, Richardson K, Eccles D, Jensen T, Osther PJ, van Asperen CJ, Vasen H, Kiemeney LA, Ringelberg J, Cybulski C, Wokolorczyk D, Hart R, Glover W, Lam J, Taylor L, Salinas M, Feliubadaló L, Oldenburg R, Cremers R, Verhaegh G, van Zelst-Stams WA, Oosterwijk JC, Cook J, Rosario DJ, Buys SS, Conner T, Domchek S, Powers J, Ausems MGEM, Teixeira MR, Maia S, Izatt L, Schmutzler R, Rhiem K, Foulkes WD, Boshari T, Davidson R, Ruijs M, Helderman-van den Enden ATJM, Andrews L, Walker L, Snape K, Henderson A, Jobson I, Lindeman GJ, Liljegren A, Harris M, Adank MA, Kirk J, Taylor A, Susman R, Chen-Shtoyerman R, Pachter N, Spigelman A, Side L, Zgajnar J, Mora J, Brewer C, Gadea N, Brady AF, Gallagher D, van Os T, Donaldson A, Stefansdottir V, Barwell J, James PA, Murphy D, Friedman E, Nicolai N, Greenhalgh L, Obeid E, Murthy V, Copakova L, McGrath J, Teo SH, Strom S, Kast K, Leongamornlert DA, Chamberlain A, Pope J, Newlin AC, Aaronson N, Ardern-Jones A, Bangma C, Castro E, Dearnaley D, Eyfjord J, Falconer A, Foster CS, Gronberg H, Hamdy FC, Johannsson O, Khoo V, Lubinski J, Grindedal EM, McKinley J, Shackleton K, Mitra AV, Moynihan C, Rennert G, Suri M, Tricker K, Moss S, Kote-Jarai Z, Vickers A, Lilja H, Helfand BT, Eeles RA. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition. Br J Cancer 2018; 118:266-276. [PMID: 29301143 PMCID: PMC5785754 DOI: 10.1038/bjc.2017.429] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA and PSAV for identifying PrCa and high-grade disease in this cohort. METHODS PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV. RESULTS 1634 participants had ⩾3 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA >3.0 ng ml-l, PSAV was not significantly associated with presence of cancer or high-grade disease. PSAV did not add to PSA for predicting time to an elevated PSA. When comparing BRCA1/2 carriers to non-carriers, we found a significant interaction between BRCA status and last PSA before biopsy (P=0.031) and BRCA2 status and PSAV (P=0.024). However, PSAV was not predictive of biopsy outcome in BRCA2 carriers. CONCLUSIONS PSA is more strongly predictive of PrCa in BRCA carriers than non-carriers. We did not find evidence that PSAV aids decision-making for BRCA carriers over absolute PSA value alone.
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Affiliation(s)
| | - Christina G Hutten Selkirk
- The John and Carol Walter Center for Urological Health, Department of Surgery, North Shore University Health System, Evanston, IL 60201, USA
- Center for Medical Genetics, Department of Medicine, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Sibel Saya
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Elizabeth Bancroft
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
| | - Emily Vertosick
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Tokhir Dadaev
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Charles Brendler
- The John and Carol Walter Center for Urological Health, Department of Surgery, North Shore University Health System, Evanston, IL 60201, USA
| | - Elizabeth Page
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Alexander Dias
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
| | - D Gareth Evans
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Jeanette Rothwell
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - Lovise Maehle
- Department of Medical Genetics, Oslo University Hospital, Oslo 0372, Norway
| | - Karol Axcrona
- Akershus University Hospital, Lørenskog 1478, Norway
| | - Kate Richardson
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, VIC 3000, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC 3010, Australia
| | - Diana Eccles
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton SO16 5YA, UK
- Cancer Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Thomas Jensen
- Department of Clinical Genetics, Vejle Hospital, Vejle 7100, Denmark
| | - Palle J Osther
- Department of Clinical Genetics, Vejle Hospital, Vejle 7100, Denmark
| | - Christi J van Asperen
- Leiden University Medical Center, Department of Clinical Genetics, Leiden, ZA 2333, The Netherlands
| | - Hans Vasen
- Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, ZA 2333, The Netherlands
| | | | - Janneke Ringelberg
- Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, ZA 2333, The Netherlands
| | - Cezary Cybulski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 70-204, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 70-204, Poland
| | - Rachel Hart
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham B15 2TG, UK
| | - Wayne Glover
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham B15 2TG, UK
| | - Jimmy Lam
- Department of Urology, Repatriation General Hospital, Daw Park, SA 5041, Australia
| | - Louise Taylor
- Department of Urology, Repatriation General Hospital, Daw Park, SA 5041, Australia
| | - Monica Salinas
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL, CIBERONC), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Lidia Feliubadaló
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL, CIBERONC), L’Hospitalet de Llobregat, Barcelona 08908, Spain
| | - Rogier Oldenburg
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam 3015 CE, The Netherlands
| | - Ruben Cremers
- Radboud University Medical Center, Nijmegen, GA 6525, The Netherlands
| | - Gerald Verhaegh
- Radboud University Medical Center, Nijmegen, GA 6525, The Netherlands
| | - Wendy A van Zelst-Stams
- Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, ZA 2333, The Netherlands
| | - Jan C Oosterwijk
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, The Netherlands
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield S10 2TH, UK
| | | | - Saundra S Buys
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT 84103, USA
| | - Tom Conner
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT 84103, USA
| | - Susan Domchek
- Basser Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jacquelyn Powers
- Basser Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Margreet GEM Ausems
- Department of Genetics, University Medical Centre Utrecht, Utrecht, CX, The Netherlands
| | - Manuel R Teixeira
- Genetics Department and Research Center, Portuguese Oncology Institute, Porto 4200-072, Portugal
- Biomedical Sciences Institute (ICBAS), Porto University, Porto 4200-072, Portugal
| | - Sofia Maia
- Genetics Department and Research Center, Portuguese Oncology Institute, Porto 4200-072, Portugal
| | - Louise Izatt
- South East Thames Genetics Service, Guy’s Hospital, London SE1 9RT, UK
| | - Rita Schmutzler
- Center of Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne 50937, Germany
| | - Kerstin Rhiem
- Center of Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne 50937, Germany
| | - William D Foulkes
- McGill Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, QC H3A 0G4, Canada
| | - Talia Boshari
- McGill Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, QC H3A 0G4, Canada
| | - Rosemarie Davidson
- Duncan Guthrie Institute of Medical Genetics, Yorkhill NHS Trust, Glasgow G38SJ, UK
| | - Marielle Ruijs
- The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands
| | | | - Lesley Andrews
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Lisa Walker
- Churchill Hospital, Headington, Oxford OX3 7LE, UK
| | - Katie Snape
- St George’s Hospital, Tooting, London SW17 0QT, UK
| | - Alex Henderson
- Northern Genetics Service, Newcastle upon Tyne Hospitals, Newcastle NE1 3BZ, UK
| | - Irene Jobson
- Northern Genetics Service, Newcastle upon Tyne Hospitals, Newcastle NE1 3BZ, UK
| | - Geoffrey J Lindeman
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia
- Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3050, Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Annelie Liljegren
- Karolinska University Hospital and Karolinska Institutet, Solna 171 77, Sweden
| | - Marion Harris
- Familial Cancer Centre, Monash Health, Clayton, VIC 3168, Australia
| | - Muriel A Adank
- VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Judy Kirk
- Familial Cancer Service, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Sydney, NSW 2155, Australia
| | - Amy Taylor
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Rachel Susman
- Genetic Health Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Australia
| | | | - Nicholas Pachter
- Genetic Services of WA, King Edward Memorial Hospital, Subiaco, WA 6008, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA 6009, Australia
| | - Allan Spigelman
- Hunter Family Cancer Service, Waratah, NSW 2298, Australia
- University of New South Wales, St Vincent’s Clinical School, NSW 2052, Australia
- The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW 2010, Australia
| | - Lucy Side
- NE Thames Regional Genetics Service, Great Ormond St Hospital & UCL Institute of Women’s Health, London WC1N 3JH, UK
| | | | | | - Carole Brewer
- Peninsular Genetics, Derriford Hospital, Plymouth PL6 8DH, UK
- Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
| | - Neus Gadea
- High Risk and Cancer Prevention Clinic, Vall d'Hebron University Hospital, Barcelona 08035, Spain
| | - Angela F Brady
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, London HA1 3UJ, UK
| | | | - Theo van Os
- Academic Medical Center, Amsterdam 1105 AZ, The Netherlands
| | | | | | - Julian Barwell
- University of Leicester, Leicester LE1 7RH, UK
- University Hospitals Leicester, Leicester LE1 5WW, UK
| | - Paul A James
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, VIC 3000, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC 3010, Australia
- Genetic Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
| | - Declan Murphy
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC 3010, Australia
| | - Eitan Friedman
- Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
| | | | - Lynn Greenhalgh
- Cheshire and Mersey Clinical Genetics Service, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
| | - Elias Obeid
- Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Vedang Murthy
- Tata Memorial Centre, Mumbai, Maharashtra 400012, India
| | - Lucia Copakova
- National Cancer Institute, Bratislava 83310, Slovak Republic
| | - John McGrath
- Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
| | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Subang Jaya Medical Centre, Subang Jaya, Selangor 47500, Darul Ehsan, Malaysia
| | - Sara Strom
- The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Karin Kast
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01069, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden 01307, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | | | - Anthony Chamberlain
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Jenny Pope
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Anna C Newlin
- Center for Medical Genetics, Department of Medicine, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Neil Aaronson
- The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands
| | | | - Chris Bangma
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam 3015 CE, The Netherlands
| | - Elena Castro
- Prostate Cancer Unit, Spanish National Cancer Research Centre, Madrid 28029, Spain
| | - David Dearnaley
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
| | - Jorunn Eyfjord
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik 101, Iceland
| | - Alison Falconer
- Imperial College Healthcare NHS Trust, London, London W2 1NY, UK
| | | | | | - Freddie C Hamdy
- Churchill Hospital, Headington, Oxford OX3 7LE, UK
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX1 2JD, UK
| | - Oskar Johannsson
- Landspitali—the National University Hospital of Iceland, Reykjavik 101, Iceland
| | - Vincent Khoo
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 70-204, Poland
| | | | - Joanne McKinley
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, VIC 3000, Australia
| | - Kylie Shackleton
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia
| | - Anita V Mitra
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
| | - Clare Moynihan
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Gad Rennert
- CHS National Cancer Control Center, Carmel Medical Center, Haifa 3436212, Israel
| | - Mohnish Suri
- Nottingham City Hospital, Nottingham NG5 1PB, UK
| | - Karen Tricker
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
| | - The IMPACT study collaborators91
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- The John and Carol Walter Center for Urological Health, Department of Surgery, North Shore University Health System, Evanston, IL 60201, USA
- Center for Medical Genetics, Department of Medicine, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Genomic Medicine, Manchester Academic Health Sciences Centre, Division of Evolution and Genomic Sciences, University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, UK
- Department of Medical Genetics, Oslo University Hospital, Oslo 0372, Norway
- Akershus University Hospital, Lørenskog 1478, Norway
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, VIC 3000, Australia
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC 3010, Australia
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton SO16 5YA, UK
- Cancer Sciences, Faculty of Medicine, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Department of Clinical Genetics, Vejle Hospital, Vejle 7100, Denmark
- Leiden University Medical Center, Department of Clinical Genetics, Leiden, ZA 2333, The Netherlands
- Netherlands Foundation for the Detection of Hereditary Tumors, Leiden, ZA 2333, The Netherlands
- Radboud University Medical Center, Nijmegen, GA 6525, The Netherlands
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin 70-204, Poland
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham B15 2TG, UK
- Department of Urology, Repatriation General Hospital, Daw Park, SA 5041, Australia
- Hereditary Cancer Program, Catalan Institute of Oncology (ICO-IDIBELL, CIBERONC), L’Hospitalet de Llobregat, Barcelona 08908, Spain
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam 3015 CE, The Netherlands
- Department of Genetics, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, The Netherlands
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield S10 2TH, UK
- Royal Hallamshire Hospital, Sheffield S10 2JF, UK
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT 84103, USA
- Basser Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Genetics, University Medical Centre Utrecht, Utrecht, CX, The Netherlands
- Genetics Department and Research Center, Portuguese Oncology Institute, Porto 4200-072, Portugal
- Biomedical Sciences Institute (ICBAS), Porto University, Porto 4200-072, Portugal
- South East Thames Genetics Service, Guy’s Hospital, London SE1 9RT, UK
- Center of Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne 50937, Germany
- McGill Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, QC H3A 0G4, Canada
- Duncan Guthrie Institute of Medical Genetics, Yorkhill NHS Trust, Glasgow G38SJ, UK
- The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands
- Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, HX 6229, The Netherlands
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, NSW 2031, Australia
- Churchill Hospital, Headington, Oxford OX3 7LE, UK
- St George’s Hospital, Tooting, London SW17 0QT, UK
- Northern Genetics Service, Newcastle upon Tyne Hospitals, Newcastle NE1 3BZ, UK
- Parkville Familial Cancer Centre, The Royal Melbourne Hospital, Grattan St, Parkville, VIC 3050, Australia
- Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3050, Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
- Karolinska University Hospital and Karolinska Institutet, Solna 171 77, Sweden
- Familial Cancer Centre, Monash Health, Clayton, VIC 3168, Australia
- VU University Medical Center, Amsterdam 1081 HV, The Netherlands
- Familial Cancer Service, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia
- Centre for Cancer Research, The Westmead Institute for Medical Research, Westmead, Sydney, NSW 2155, Australia
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Genetic Health Queensland, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Australia
- The Genetic Institute, Kaplan Medical Center, Rehovot 76100, Israel
- Genetic Services of WA, King Edward Memorial Hospital, Subiaco, WA 6008, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, WA 6009, Australia
- Hunter Family Cancer Service, Waratah, NSW 2298, Australia
- University of New South Wales, St Vincent’s Clinical School, NSW 2052, Australia
- The Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW 2010, Australia
- NE Thames Regional Genetics Service, Great Ormond St Hospital & UCL Institute of Women’s Health, London WC1N 3JH, UK
- Institute of Oncology, Ljubljana 1000, Slovenia
- Hospital de Sant Pau, Barcelona 08041, Spain
- Peninsular Genetics, Derriford Hospital, Plymouth PL6 8DH, UK
- Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK
- High Risk and Cancer Prevention Clinic, Vall d'Hebron University Hospital, Barcelona 08035, Spain
- North West Thames Regional Genetics Service, London North West Healthcare NHS Trust, London HA1 3UJ, UK
- St James’ Hospital, Dublin 8, Ireland
- Academic Medical Center, Amsterdam 1105 AZ, The Netherlands
- St Michael’s Hospital, Bristol BS2 8EG, UK
- Landspitali—the National University Hospital of Iceland, Reykjavik 101, Iceland
- University of Leicester, Leicester LE1 7RH, UK
- University Hospitals Leicester, Leicester LE1 5WW, UK
- Genetic Medicine, Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
- Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Istituto Nazionale dei Tumori, Milano 20133, Italy
- Cheshire and Mersey Clinical Genetics Service, Liverpool Women’s Hospital, Liverpool L8 7SS, UK
- Fox Chase Cancer Center, Philadelphia, PA 19111, USA
- Tata Memorial Centre, Mumbai, Maharashtra 400012, India
- National Cancer Institute, Bratislava 83310, Slovak Republic
- Cancer Research Initiatives Foundation, Subang Jaya Medical Centre, Subang Jaya, Selangor 47500, Darul Ehsan, Malaysia
- The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Gynecology and Obstetrics, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01069, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden 01307, Germany
- German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
- Prostate Cancer Unit, Spanish National Cancer Research Centre, Madrid 28029, Spain
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik 101, Iceland
- Imperial College Healthcare NHS Trust, London, London W2 1NY, UK
- HCA Healthcare Laboratories, London WC1E 6JA, UK
- University Hospital, Umea 907 37, Sweden
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX1 2JD, UK
- University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK
- CHS National Cancer Control Center, Carmel Medical Center, Haifa 3436212, Israel
- Nottingham City Hospital, Nottingham NG5 1PB, UK
- The IMPACT Study Collaborators List see Appendix 1
- Centre for Cancer Prevention, Queen Mary University of London, London EC1M 6BQ
- Departments of Laboratory Medicine, Surgery, and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Translational Medicine, Lund University, Malmö 205 02, Sweden
| | - Sue Moss
- Centre for Cancer Prevention, Queen Mary University of London, London EC1M 6BQ
| | - Zsofia Kote-Jarai
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Hans Lilja
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX1 2JD, UK
- Departments of Laboratory Medicine, Surgery, and Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Brian T Helfand
- The John and Carol Walter Center for Urological Health, Department of Surgery, North Shore University Health System, Evanston, IL 60201, USA
| | - Rosalind A Eeles
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, Surrey SM2 5NG, UK
- Royal Marsden NHS Foundation Trust, Fulham Rd, London SW3 6JJ, UK
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Leão RRN, Price AJ, James Hamilton R. Germline BRCA mutation in male carriers-ripe for precision oncology? Prostate Cancer Prostatic Dis 2017; 21:48-56. [PMID: 29242595 DOI: 10.1038/s41391-017-0018-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 08/20/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Prostate cancer (PC) is one of the known heritable cancers with individual variations attributed to genetic factors. BRCA1 and BRCA2 are tumour suppressor genes with crucial roles in repairing DNA and thereby maintaining genomic integrity. Germline BRCA mutations predispose to multiple familial tumour types including PC. METHODS We performed a Pubmed database search along with review of reference lists from prominent articles to capture papers exploring the association between BRCA mtuations and prostate cancer risk and prognosis. Articles were retrieved until May 2017 and filtered for relevance, and publication type. RESULTS We explored familial PC genetics; discussed the discovery and magnitude of the association between BRCA mutations and PC risk and outcome; examined implications of factoring BRCA mutations into PC screening; and discussed the rationale for chemoprevention in this high-risk population. We confirmed that BRCA1/2 mutations confer an up to 4.5-fold and 8.3-fold increased risk of PC, respectively. BRCA2 mutations are associated with an increased risk of high-grade disease, progression to metastatic castration-resistant disease, and 5-year cancer-specific survival rates of 50 to 60%. CONCLUSION Despite the growing body of research on DNA repair genes, deeper analysis is needed to understand the aetiological role of germline BRCA mutations in the natural history of PC. There is a need for awareness to screen for this marker of PC risk. There is similarly an opportunity for structured PC screening programs for BRCA mutation carriers. Finally, further research is required to identify potential chemopreventive strategies for this high-risk subgroup.
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Affiliation(s)
| | - Aryeh Joshua Price
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA, USA
| | - Robert James Hamilton
- Urology Division, Department of Surgery, University of Toronto, Toronto, ON, Canada.
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Is there a difference in testosterone levels and its regulators in men carrying BRCA mutations? Oncotarget 2017; 8:103843-103850. [PMID: 29262604 PMCID: PMC5732770 DOI: 10.18632/oncotarget.21802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 09/16/2017] [Indexed: 11/25/2022] Open
Abstract
Background Male BRCA mutation carriers are at risk for an early onset aggressive prostate cancer. No data exist on the association of testosterone levels among these patients. We aimed to analyze testosterone and associated hormonal levels among male BRCA carriers and non-carriers. Patients and methods Overall 87 male carriers and 43 non-carriers aged 40-70 were prospectively enrolled. Clinical data were collected and all patients were tested for total testosterone (TT), prostate specific antigen (PSA), follicle stimulating hormone (FSH), luteinizing hormone (LH), free androgen index (FAI), sex hormone binding globulin (SHBG) and prolactin. Multivariate linear regression analysis was performed to predict TT levels. Results The median age, mean BMI, comorbidities, PSA, FSH, LH and SHBG levels in both groups were similar. However, mean TT and FAI were higher in the carriers (16.7 nmol/l vs 13.5 nmol/l, p=0.03 and 39.5 vs 34.8, p=0.05, respectively), while prolactin was significantly lower. Multivariate analysis demonstrated that while BMI was inversely correlated to TT levels in both groups, LH was a predictor only in non-carriers. Conclusions Carriers have higher TT and FAI levels and lower prolactin levels; but LH does not predict their TT levels. Further research in a larger cohort of BRCA carriers with and without prostate cancer should be performed.
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25
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Yamauchi H, Takei J. Management of hereditary breast and ovarian cancer. Int J Clin Oncol 2017; 23:45-51. [PMID: 29185095 DOI: 10.1007/s10147-017-1208-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 10/16/2017] [Indexed: 02/05/2023]
Abstract
Hereditary breast and ovarian cancer (HBOC) syndrome represents 5-10% of all breast cancers. In Japan, the HBOC syndrome is frequently diagnosed in patients with breast cancer. Therefore, a treatment strategy combining a plan for existing breast cancer and for reduction of future breast and ovarian cancer risk is necessary. Breast cancer risk-reducing management involves three options-surveillance, chemoprevention, and risk-reducing mastectomy (RRM). RRM can prevent >90% of new breast cancers. Ovarian cancer risk management options are more limited, and risk-reduction salpingo-oophorectomy is the only option since there is no proven effective early detection method available. The local recurrence rate following breast-conserving surgery in BRCA1/2 mutation-associated breast cancer is not significantly higher than that in sporadic breast cancer. Furthermore, there is no difference in prognosis between surgical methods. Clinicians should inform patients that there are no data on long-term monitoring and fully discuss risks of re-developing breast cancer with patients when choosing the surgical method. In HBOC, BRCA1/2 mutations lead to failure of double-strand DNA break repair, with poly ADP-ribose polymerase (PARP) playing an important role in single-strand DNA nick repair. Use of PARP inhibitors in HBOC prevents DNA repair (synthetic lethality) leading to cell death. This review summarizes management of the HBOC syndrome based on recent evidence.
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Affiliation(s)
- Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's Internation Hospital, Tokyo, Japan.
| | - Junko Takei
- Department of Breast Surgical Oncology, St. Luke's Internation Hospital, Tokyo, Japan
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26
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Investigating BRCA Mutations: A Breakthrough in Precision Medicine of Castration-Resistant Prostate Cancer. Target Oncol 2017; 11:569-577. [PMID: 27402433 DOI: 10.1007/s11523-016-0450-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Despite the development of novel effective therapeutic strategies, metastatic castration-resistant prostate cancer (mCRPC) remains a disease with a lethal course and a high biological and molecular heterogeneity. To date, germline mutations in the BRCA gene represent one of the main risk factors for developing prostate cancer, with a strong association with aggressive phenotype and poor clinical outcomes. A better understanding of the genomic landscape of prostate cancer has strengthened the idea that "synthetic lethality" of this disease might be useful in cancer-drug discovery, focusing on agents such as platinum compounds and poly (adenosine diphosphate [ADP]-ribose) polymerase inhibitors (PARPi). In this review, we summarize the main data available on BRCA mutations and discuss the clinical implications of these genomic aberrations in the management of prostate cancer, stressing the need to identify prognostic and predictive biomarkers and to deeply understand the mechanisms of treatment resistance, in order to maximize personalized medicine protocols and therefore clinical benefit.
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27
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Penel N. [Prostate cancer and DNA repair genes]. Bull Cancer 2017; 104:958-961. [PMID: 29032803 DOI: 10.1016/j.bulcan.2017.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 07/20/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Nicolas Penel
- Centre Oscar-Lambret, département de cancérologie générale, 3, rue F.-Combemale, 59000 Lille, France.
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28
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Giri VN, Obeid E, Gross L, Bealin L, Hyatt C, Hegarty SE, Montgomery S, Forman A, Bingler R, Kelly WK, Dicker AP, Winheld S, Trabulsi EJ, Chen DY, Lallas CD, Allen BA, Daly MB, Gomella LG. Inherited Mutations in Men Undergoing Multigene Panel Testing for Prostate Cancer: Emerging Implications for Personalized Prostate Cancer Genetic Evaluation. JCO Precis Oncol 2017; 1:PO.16.00039. [PMID: 34164591 PMCID: PMC8210976 DOI: 10.1200/po.16.00039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Multigene panels are commercially available for the evaluation of prostate cancer (PCA) predisposition, which necessitates tailored genetic counseling (GC) for men. Here we describe emerging results of Genetic Evaluation of Men, prospective multigene testing study in PCA to inform personalized genetic counseling, with emerging implications for referrals, cancer screening, and precision therapy. PATIENTS AND METHODS Eligibility criteria for men affected by or at high risk for PCA encompass age, race, family history (FH), and PCA stage/grade. Detailed demographic, clinical, and FH data were obtained from participants and medical records. Multigene testing was conducted after GC. Mutation rates were summarized by eligibility criteria and compared across FH data. The 95% CI of mutation prevalence was constructed by using Poisson distribution. RESULTS Of 200 men enrolled, 62.5% had PCA. Eleven (5.5%; 95% CI, 3.0% to 9.9%) had mutations; 63.6% of mutations were in DNA repair genes. FH of breast cancer was significantly associated with mutation status (P = .004), and FH that met criteria for hereditary breast and ovarian cancer syndrome was significantly associated with PCA (odds ratio, 2.33; 95% CI, 1.05 to 5.18). Variants of uncertain significance were reported in 70 men (35.0%). Among mutation carriers, 45.5% had personal/FH concordant with the gene. A tailored GC model was developed based on emerging findings. CONCLUSION Multigene testing for PCA identifies mutations mostly in DNA repair genes, with implications for precision therapy. The study highlights the importance of comprehensive genetic evaluation for PCA beyond metastatic disease, including early-stage disease with strong FH. Detailed FH is important for referrals of men for genetic evaluation. The results inform precision GC and cancer screening for men and their male and female blood relatives.
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Affiliation(s)
- Veda N. Giri
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Elias Obeid
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Laura Gross
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Lisa Bealin
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Colette Hyatt
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Sarah E. Hegarty
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Susan Montgomery
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Andrea Forman
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Ruth Bingler
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - William K. Kelly
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Adam P. Dicker
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Stephanie Winheld
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Edouard J. Trabulsi
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - David Y.T. Chen
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Costas D. Lallas
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Brian A. Allen
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Mary B. Daly
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
| | - Leonard G. Gomella
- Veda N. Giri, Laura Gross, Colette Hyatt, Sarah E. Hegarty, William K. Kelly, Adam P. Dicker, Stephanie Winheld, Edouard J. Trabulsi, Costas D. Lallas, and Leonard G. Gomella, Thomas Jefferson University; Elias Obeid, Lisa Bealin, Susan Montgomery, Andrea Forman, Ruth Bingler, David Y.T. Chen, and Mary B. Daly, Fox Chase Cancer Center, Philadelphia, PA; and Brian A. Allen, Myriad Genetics, Salt Lake City, UT
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29
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Abstract
Prostate cancer is the most commonly diagnosed cancer among men in the United States as well as most Western countries. A significant proportion of men report having a positive family history of prostate cancer in a first-degree relative (father, brother, son), which is important in that family history is one of the only established risk factors for the disease and plays a role in decision-making for prostate cancer screening. Familial aggregation of prostate cancer is considered a surrogate marker of genetic susceptibility to developing the disease, but shared environment cannot be excluded as an explanation for clustering of cases among family members. Prostate cancer is both a clinically and genetically heterogeneous disease with inherited factors predicted to account for 40%-50% of cases, comprised of both rare highly to moderately penetrant gene variants, as well as common genetic variants of low penetrance. Most notably, HOXB13 and BRCA2 mutations have been consistently shown to increase prostate cancer risk, and are more commonly observed among patients diagnosed with early-onset disease. A recurrent mutation in HOXB13 has been shown to predispose to hereditary prostate cancer (HPC), and BRCA2 mutations to hereditary breast and ovarian cancer (HBOC). Genome-wide association studies (GWAS) have also identified approximately 100 loci that associate with modest (odds ratios <2.0) increases in prostate cancer risk, only some of which have been replicated in subsequent studies. Despite these efforts, genetic testing in prostate cancer lags behind other common tumors like breast and colorectal cancer. To date, National Comprehensive Cancer Network (NCCN) guidelines have highly selective criteria for BRCA1/2 testing for men with prostate cancer based on personal history and/or specific family cancer history. Tumor sequencing is also leading to the identification of germline mutations in prostate cancer patients, informing the scope of inheritance. Advances in genetic testing for inherited and familial prostate cancer (FPC) are needed to inform personalized cancer risk screening and treatment approaches.
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Affiliation(s)
- Veda N Giri
- Cancer Risk Assessment and Clinical Cancer Genetics Program, Division of Population Science, Department of Medical Oncology, Center of Excellence for Cancer Risk, Prevention, and Control Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA.
| | - Jennifer L Beebe-Dimmer
- Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine Department of Oncology, Detroit, MI
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Walker R, Louis A, Berlin A, Horsburgh S, Bristow RG, Trachtenberg J. Prostate cancer screening characteristics in men with BRCA1/2 mutations attending a high-risk prevention clinic. Can Urol Assoc J 2014; 8:E783-8. [PMID: 25485004 DOI: 10.5489/cuaj.1970] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The prostate-specific antigen (PSA) era and resultant early detection of prostate cancer has presented clinicians with the challenge of distinguishing indolent from aggressive tumours. Mutations in the BRCA1/2 genes have been associated with prostate cancer risk and prognosis. We describe the prostate cancer screening characteristics of BRCA1/2 mutation carriers, who may be classified as genetically-defined high risk, as compared to another high-risk cohort of men with a family history of prostate cancer to evaluate the utility of a targeted screening approach for these men. METHODS We reviewed patient demographics, clinical screening characteristics, pathological features, and treatment outcomes between a group of BRCA1 or BRCA2 mutation carriers and age-matched men with a family history of prostate cancer followed at our institutional Prostate Cancer Prevention Clinic from 1995 to 2012. RESULTS Screening characteristics were similar between the mutation carriers (n = 53) and the family history group (n = 53). Some cancers would be missed in both groups by using a PSA cut-off of >4 ug/L. While cancer detection was higher in the family history group (21% vs. 15%), the mutation carrier group was more likely to have intermediate- or high-risk disease (88% vs. 36%). BRCA2 mutation carriers were more likely to have aggressive disease, biological recurrence, and distant metastasis. CONCLUSIONS In our cohort, regular screening appears justified for detecting prostate cancer in BRCA1 and BRCA2 carriers and other high-risk populations. Lowering PSA cut-offs and defining monitoring of PSA velocity as part of the screening protocol may be useful. BRCA2 is associated with more aggressive disease, while the outcome for BRCA1 mutation carriers requires further study. Large multinational studies will be important to define screening techniques for this unique high-risk population.
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Affiliation(s)
- Richard Walker
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - Alyssa Louis
- Department of Surgical Oncology, University Health Network, Toronto, ON
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - Sheri Horsburgh
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - Robert G Bristow
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON
| | - John Trachtenberg
- Department of Surgical Oncology, University Health Network, Toronto, ON
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Bancroft EK, Page EC, Castro E, Lilja H, Vickers A, Sjoberg D, Assel M, Foster CS, Mitchell G, Drew K, Mæhle L, Axcrona K, Evans DG, Bulman B, Eccles D, McBride D, van Asperen C, Vasen H, Kiemeney LA, Ringelberg J, Cybulski C, Wokolorczyk D, Selkirk C, Hulick PJ, Bojesen A, Skytte AB, Lam J, Taylor L, Oldenburg R, Cremers R, Verhaegh G, van Zelst-Stams WA, Oosterwijk JC, Blanco I, Salinas M, Cook J, Rosario DJ, Buys S, Conner T, Ausems MG, Ong KR, Hoffman J, Domchek S, Powers J, Teixeira MR, Maia S, Foulkes WD, Taherian N, Ruijs M, Helderman-van den Enden AT, Izatt L, Davidson R, Adank MA, Walker L, Schmutzler R, Tucker K, Kirk J, Hodgson S, Harris M, Douglas F, Lindeman GJ, Zgajnar J, Tischkowitz M, Clowes VE, Susman R, Ramón y Cajal T, Patcher N, Gadea N, Spigelman A, van Os T, Liljegren A, Side L, Brewer C, Brady AF, Donaldson A, Stefansdottir V, Friedman E, Chen-Shtoyerman R, Amor DJ, Copakova L, Barwell J, Giri VN, Murthy V, Nicolai N, Teo SH, Greenhalgh L, Strom S, Henderson A, McGrath J, Gallagher D, Aaronson N, Ardern-Jones A, Bangma C, Dearnaley D, Costello P, Eyfjord J, Rothwell J, Falconer A, Gronberg H, Hamdy FC, Johannsson O, Khoo V, Kote-Jarai Z, Lubinski J, Axcrona U, Melia J, McKinley J, Mitra AV, Moynihan C, Rennert G, Suri M, Wilson P, Killick E, Moss S, Eeles RA. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: results from the initial screening round of the IMPACT study. Eur Urol 2014; 66:489-99. [PMID: 24484606 PMCID: PMC4105321 DOI: 10.1016/j.eururo.2014.01.003] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 01/02/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls) is an international consortium of 62 centres in 20 countries evaluating the use of targeted PCa screening in men with BRCA1/2 mutations. OBJECTIVE To report the first year's screening results for all men at enrollment in the study. DESIGN, SETTING AND PARTICIPANTS We recruited men aged 40-69 yr with germline BRCA1/2 mutations and a control group of men who have tested negative for a pathogenic BRCA1 or BRCA2 mutation known to be present in their families. All men underwent prostate-specific antigen (PSA) testing at enrollment, and those men with PSA >3 ng/ml were offered prostate biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS PSA levels, PCa incidence, and tumour characteristics were evaluated. The Fisher exact test was used to compare the number of PCa cases among groups and the differences among disease types. RESULTS AND LIMITATIONS We recruited 2481 men (791 BRCA1 carriers, 531 BRCA1 controls; 731 BRCA2 carriers, 428 BRCA2 controls). A total of 199 men (8%) presented with PSA >3.0 ng/ml, 162 biopsies were performed, and 59 PCas were diagnosed (18 BRCA1 carriers, 10 BRCA1 controls; 24 BRCA2 carriers, 7 BRCA2 controls); 66% of the tumours were classified as intermediate- or high-risk disease. The positive predictive value (PPV) for biopsy using a PSA threshold of 3.0 ng/ml in BRCA2 mutation carriers was 48%-double the PPV reported in population screening studies. A significant difference in detecting intermediate- or high-risk disease was observed in BRCA2 carriers. Ninety-five percent of the men were white, thus the results cannot be generalised to all ethnic groups. CONCLUSIONS The IMPACT screening network will be useful for targeted PCa screening studies in men with germline genetic risk variants as they are discovered. These preliminary results support the use of targeted PSA screening based on BRCA genotype and show that this screening yields a high proportion of aggressive disease. PATIENT SUMMARY In this report, we demonstrate that germline genetic markers can be used to identify men at higher risk of prostate cancer. Targeting screening at these men resulted in the identification of tumours that were more likely to require treatment.
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Affiliation(s)
- Elizabeth K Bancroft
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK; Oncogenetics Team, Institute of Cancer Research, London, UK
| | | | - Elena Castro
- Oncogenetics Team, Institute of Cancer Research, London, UK; Spanish National Cancer Research Centre, Madrid, Spain
| | - Hans Lilja
- Departments of Laboratory Medicine, Surgery, and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Institute of Biomedical Technology, University of Tampere, Tampere, Finland; Department of Laboratory Medicine, Lund University, Malmö, Sweden
| | - Andrew Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Daniel Sjoberg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | | | - Gillian Mitchell
- Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Drew
- Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | | | | | - D Gareth Evans
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Barbara Bulman
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Diana Eccles
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Donna McBride
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | | | - Hans Vasen
- Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands
| | | | - Janneke Ringelberg
- Foundation for the Detection of Hereditary Tumours, Leiden, The Netherlands
| | - Cezary Cybulski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Dominika Wokolorczyk
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Christina Selkirk
- Center for Medical Genetics, NorthShore University HealthSystem, Evanston, IL, USA
| | - Peter J Hulick
- Center for Medical Genetics, NorthShore University HealthSystem, Evanston, IL, USA; Priztker School of Medicine, University of Chicago, Chicago, IL, USA
| | | | | | - Jimmy Lam
- Department of Urology, Repatriation General Hospital, Daw Park, South Australia, Australia
| | - Louise Taylor
- Department of Urology, Repatriation General Hospital, Daw Park, South Australia, Australia
| | | | - Ruben Cremers
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gerald Verhaegh
- Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Jan C Oosterwijk
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ignacio Blanco
- Hereditary Cancer Program, Catalonian Institute of Oncology, L'Hospitalet, Barcelona, Spain
| | - Monica Salinas
- Hereditary Cancer Program, Catalonian Institute of Oncology, L'Hospitalet, Barcelona, Spain
| | - Jackie Cook
- Sheffield Clinical Genetics Service, Sheffield Children's Hospital, Sheffield, UK
| | | | - Saundra Buys
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Tom Conner
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Margreet G Ausems
- Department of Medical Genetics, University Medical Centre Utrecht, The Netherlands
| | - Kai-ren Ong
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham, UK
| | - Jonathan Hoffman
- Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham, UK
| | - Susan Domchek
- Basser Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacquelyn Powers
- Basser Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Manuel R Teixeira
- Genetics Department and Research Center, Portuguese Oncology Institute, Porto, Portugal; Biomedical Sciences Institute (ICBAS), Porto University, Porto, Portugal
| | - Sofia Maia
- Genetics Department and Research Center, Portuguese Oncology Institute, Porto, Portugal
| | - William D Foulkes
- McGill Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Nassim Taherian
- McGill Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Marielle Ruijs
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Louise Izatt
- South East Thames Genetics Service, London, UK, Guy's Hospital, London, UK
| | - Rosemarie Davidson
- Duncan Guthrie Institute of Medical Genetics, Yorkhill NHS Trust, Glasgow, UK
| | - Muriel A Adank
- VU University Medical Center, Amsterdam, The Netherlands
| | | | - Rita Schmutzler
- Center of Familial Breast and Ovarian Cancer, University Hospital of Cologne, Cologne, Germany
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Randwick, New South Wales, Australia; Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Judy Kirk
- Familial Cancer Service, Westmead Hospital, Westmead, Sydney, New South Wales, Australia; Sydney Medical School (University of Sydney) at Westmead Millennium Institute, Sydney, NSW, Australia
| | | | - Marion Harris
- Familial Cancer Centre, Monash Health, Clayton, Victoria, Australia
| | - Fiona Douglas
- Northern Genetics Service, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | - Geoffrey J Lindeman
- Familial Cancer Centre, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia; Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
| | | | - Marc Tischkowitz
- Addenbrooke's Hospital, Cambridge, UK; The University of Cambridge, Cambridge, UK
| | - Virginia E Clowes
- Addenbrooke's Hospital, Cambridge, UK; The University of Cambridge, Cambridge, UK
| | - Rachel Susman
- Genetic Health Queensland, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | | | - Nicholas Patcher
- Genetic Services of WA, King Edward Memorial Hospital, Subiaco, WA, Australia; Department of Paediatrics, University of Western Australia, Perth, WA, Australia
| | - Neus Gadea
- Hospital Vall d'Hebron, Barcelona, Spain
| | - Allan Spigelman
- Hunter Family Cancer Service, Waratah, New South Wales, Australia; University of New South Wales, St. Vincent's Clinical School, Darlinghurst, New South Wales, Australia; Hereditary Cancer Clinic, The Kinghorn Cancer Centre, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Theo van Os
- Academic Medical Center, Amsterdam, The Netherlands
| | - Annelie Liljegren
- Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Lucy Side
- NE Thames Regional Genetics Service, Institute of Child Health, London, UK
| | - Carole Brewer
- Peninsular Genetics, Derriford Hospital, Plymouth, UK; Royal Devon and Exeter Hospital, Exeter, UK
| | - Angela F Brady
- North West Thames Regional Genetics Service, Kennedy-Galton Centre, North West London Hospitals NHS Trust, Harrow, UK
| | | | | | | | | | - David J Amor
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | | | - Julian Barwell
- University of Leicester, Leicester, UK; University Hospitals Leicester, Leicester, UK
| | - Veda N Giri
- Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | | | - Soo-Hwang Teo
- Cancer Research Initiatives Foundation, Subang Jaya Medical Centre, Selangor, Darul Ehsan, Malaysia
| | - Lynn Greenhalgh
- Clinical Genetics, Royal Liverpool Children's Hospital, Liverpool, UK
| | - Sara Strom
- The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Alex Henderson
- Northern Genetics Service, Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | | | | | - Neil Aaronson
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Audrey Ardern-Jones
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Chris Bangma
- Erasmus Medical Center, Rotterdam, The Netherlands
| | - David Dearnaley
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK; Oncogenetics Team, Institute of Cancer Research, London, UK
| | - Philandra Costello
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Jorunn Eyfjord
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Jeanette Rothwell
- Genetic Medicine, Manchester Academic Health Sciences Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | | | | | - Freddie C Hamdy
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Churchill Hospital, Headington, Oxford, UK
| | - Oskar Johannsson
- Landspitali-the National University Hospital of Iceland, Reykjavik, Iceland
| | - Vincent Khoo
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK
| | | | - Jan Lubinski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | | | - Jane Melia
- The University of Cambridge, Cambridge, UK
| | - Joanne McKinley
- Familial Cancer Centre, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Anita V Mitra
- Oncogenetics Team, Institute of Cancer Research, London, UK; University College London Hospitals NHS Foundation Trust, London, UK
| | - Clare Moynihan
- Oncogenetics Team, Institute of Cancer Research, London, UK
| | - Gad Rennert
- CHS National Cancer Control Center, Carmel Medical Center, Haifa, Israel
| | | | | | - Emma Killick
- Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK; Oncogenetics Team, Institute of Cancer Research, London, UK
| | - Sue Moss
- Queen Mary University of London, London, UK
| | - Rosalind A Eeles
- Oncogenetics Team, Institute of Cancer Research, London, UK; Cancer Genetics Unit and Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
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Golan T, Kanji ZS, Epelbaum R, Devaud N, Dagan E, Holter S, Aderka D, Paluch-Shimon S, Kaufman B, Gershoni-Baruch R, Hedley D, Moore MJ, Friedman E, Gallinger S. Overall survival and clinical characteristics of pancreatic cancer in BRCA mutation carriers. Br J Cancer 2014; 111:1132-8. [PMID: 25072261 PMCID: PMC4453851 DOI: 10.1038/bjc.2014.418] [Citation(s) in RCA: 301] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/19/2014] [Accepted: 06/30/2014] [Indexed: 12/12/2022] Open
Abstract
Background: The BRCA1/2 proteins are involved in regulation of cellular proliferation by DNA damage repair via homologous recombination. Therefore, BRCA1/2 mutation carriers with pancreatic cancer may have distinct biologic outcomes. Methods: Patients with BRCA1/2-associated pancreatic ductal adenocarcinoma (PDAC) diagnosed between January 1994 and December 2012 were identified from databases at three participating institutions. Clinical data were collected. Disease-free survival and overall survival (OS) were analysed. Results: Overall, 71 patients with PDAC and BRCA1 (n=21), BRCA2 (n=49) or both (n=1) mutations were identified. Mean age at diagnosis was 60.3 years (range 33–83), 81.7% (n=58) had any family history of malignancy; 30% (n=21) underwent primary resection. Out of 71 participants, 12 received experimental therapy; one patient had missing data, these 13 cases were excluded from OS analysis. Median OS for 58 patients was 14 months (95% CI 10–23 months). Median OS for patients with stage 1/2 disease has not been reached with 52% still alive at 60 months. Median OS for stage 3/4 was 12 months (95% CI 6–15). Superior OS was observed for patients with stage 3/4 treated with platinum vs those treated with non-platinum chemotherapies (22 vs 9 months; P=0.039). Conclusion: Superior OS was observed for advanced-disease BRCA-associated PDAC with platinum exposure.
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Affiliation(s)
- T Golan
- 1] The Oncology Institute the Chaim Sheba Medical Center, Tel Hashomer, Israel [2] The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Z S Kanji
- 1] Department of Surgery, University Health Network, Toronto, ON, Canada [2] Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
| | - R Epelbaum
- 1] Department of Oncology, Rambam Health Care Campus, University of Haifa, Haifa, Israel [2] Technion, Faculty of Medicine, Haifa, Israel
| | - N Devaud
- 1] Department of Surgery, University Health Network, Toronto, ON, Canada [2] Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
| | - E Dagan
- 1] Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel [2] Institute of Human Genetics, Rambam Health Care Campus, University of Haifa, Haifa, Israel
| | - S Holter
- 1] Department of Surgery, University Health Network, Toronto, ON, Canada [2] Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
| | - D Aderka
- 1] The Oncology Institute the Chaim Sheba Medical Center, Tel Hashomer, Israel [2] The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - S Paluch-Shimon
- 1] The Oncology Institute the Chaim Sheba Medical Center, Tel Hashomer, Israel [2] The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - B Kaufman
- 1] The Oncology Institute the Chaim Sheba Medical Center, Tel Hashomer, Israel [2] The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Gershoni-Baruch
- 1] Technion, Faculty of Medicine, Haifa, Israel [2] Institute of Human Genetics, Rambam Health Care Campus, University of Haifa, Haifa, Israel
| | - D Hedley
- Department of Surgery, University Health Network, Toronto, ON, Canada
| | - M J Moore
- Department of Surgery, University Health Network, Toronto, ON, Canada
| | - E Friedman
- 1] The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel [2] The Susanne Levy Gertner Oncogenetics Unit Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - S Gallinger
- 1] Department of Surgery, University Health Network, Toronto, ON, Canada [2] Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, ON, Canada
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Castro E, Goh C, Olmos D, Saunders E, Leongamornlert D, Tymrakiewicz M, Mahmud N, Dadaev T, Govindasami K, Guy M, Sawyer E, Wilkinson R, Ardern-Jones A, Ellis S, Frost D, Peock S, Evans DG, Tischkowitz M, Cole T, Davidson R, Eccles D, Brewer C, Douglas F, Porteous ME, Donaldson A, Dorkins H, Izatt L, Cook J, Hodgson S, Kennedy MJ, Side LE, Eason J, Murray A, Antoniou AC, Easton DF, Kote-Jarai Z, Eeles R. Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer. J Clin Oncol 2013; 31:1748-57. [PMID: 23569316 PMCID: PMC3641696 DOI: 10.1200/jco.2012.43.1882] [Citation(s) in RCA: 546] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To analyze the baseline clinicopathologic characteristics of prostate tumors with germline BRCA1 and BRCA2 (BRCA1/2) mutations and the prognostic value of those mutations on prostate cancer (PCa) outcomes. PATIENTS AND METHODS This study analyzed the tumor features and outcomes of 2,019 patients with PCa (18 BRCA1 carriers, 61 BRCA2 carriers, and 1,940 noncarriers). The Kaplan-Meier method and Cox regression analysis were used to evaluate the associations between BRCA1/2 status and other PCa prognostic factors with overall survival (OS), cause-specific OS (CSS), CSS in localized PCa (CSS_M0), metastasis-free survival (MFS), and CSS from metastasis (CSS_M1). RESULTS PCa with germline BRCA1/2 mutations were more frequently associated with Gleason ≥ 8 (P = .00003), T3/T4 stage (P = .003), nodal involvement (P = .00005), and metastases at diagnosis (P = .005) than PCa in noncarriers. CSS was significantly longer in noncarriers than in carriers (15.7 v 8.6 years, multivariable analyses [MVA] P = .015; hazard ratio [HR] = 1.8). For localized PCa, 5-year CSS and MFS were significantly higher in noncarriers (96% v 82%; MVA P = .01; HR = 2.6%; and 93% v 77%; MVA P = .009; HR = 2.7, respectively). Subgroup analyses confirmed the poor outcomes in BRCA2 patients, whereas the role of BRCA1 was not well defined due to the limited size and follow-up in this subgroup. CONCLUSION Our results confirm that BRCA1/2 mutations confer a more aggressive PCa phenotype with a higher probability of nodal involvement and distant metastasis. BRCA mutations are associated with poor survival outcomes and this should be considered for tailoring clinical management of these patients.
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Affiliation(s)
- Elena Castro
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Chee Goh
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - David Olmos
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Ed Saunders
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Daniel Leongamornlert
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Malgorzata Tymrakiewicz
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Nadiya Mahmud
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Tokhir Dadaev
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Koveela Govindasami
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Michelle Guy
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Emma Sawyer
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Rosemary Wilkinson
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Audrey Ardern-Jones
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Steve Ellis
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Debra Frost
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Susan Peock
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - D. Gareth Evans
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Marc Tischkowitz
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Trevor Cole
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Rosemarie Davidson
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Diana Eccles
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Carole Brewer
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Fiona Douglas
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Mary E. Porteous
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Alan Donaldson
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Huw Dorkins
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Louise Izatt
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Jackie Cook
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Shirley Hodgson
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - M. John Kennedy
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Lucy E. Side
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Jacqueline Eason
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Alex Murray
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Antonis C. Antoniou
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Douglas F. Easton
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Zsofia Kote-Jarai
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
| | - Rosalind Eeles
- Elena Castro, Chee Goh, Ed Saunders, Daniel Leongamornlert, Malgorzata Tymrakiewicz, Nadiya Mahmud, Tokhir Dadaev, Koveela Govindasami, Michelle Guy, Emma Sawyer, Rosemary Wilkinson, Zsofia Kote-Jarai, and Rosalind Eeles, Institute of Cancer Research; Elena Castro, Chee Goh, Audrey Ardern-Jones, and Rosalind Eeles, Royal Marsden National Health Service (NHS) Foundation Trust; Louise Izatt, Guy's and St Thomas' NHS Foundation Trust; Shirley Hodgson, St George's, University of London; Lucy E. Side, Great Ormond St Hospital for Children NHS Trust, London; Steve Ellis, Debra Frost, Susan Peock, Marc Tischkowitz, Antonis C. Antoniou, and Douglas F. Easton, University of Cambridge, Cambridge; D. Gareth Evans, Central Manchester University Hospitals NHS Foundation Trust, Manchester; Trevor Cole, Birmingham Women's Hospital Healthcare NHS Trust, Edgbaston, Birmingham; Rosemarie Davidson, Yorkhill Hospitals, Glasgow; Diana Eccles, Southampton University Hospitals NHS Trust, Southampton; Carole Brewer, Royal Devon & Exeter Hospital, Exeter; Fiona Douglas, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne; Mary E. Porteous, Western General Hospital, Edinburgh; Alan Donaldson, St Michael's Hospital, Bristol; Huw Dorkins, Kennedy-Galton Centre, Harrow; Jackie Cook, Sheffield Children's Hospital, Sheffield; Jacqueline Eason, Nottingham University Hospitals NHS Trust, Nottingham; Alex Murray, All Wales Medical Genetics Services, Singleton Hospital, Swansea, United Kingdom; Elena Castro and David Olmos, Spanish National Cancer Research Centre, Madrid, Spain; and M. John Kennedy, Trinity College Dublin and St James's Hospital, Dublin, Ireland
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Abstract
Prostate cancer (PCa) is one of the most common malignancies in the world with over 890 000 cases and over 258 000 deaths worldwide each year. Nearly all mortalities from PCa are due to metastatic disease, typically through tumors that evolve to be hormone-refractory or castrate-resistant. Despite intensive epidemiological study, there are few known environmental risk factors, and age and family history are the major determinants. However, there is extreme heterogeneity in PCa incidence worldwide, suggesting that major determining factors have not been described. Genome-wide association studies have been performed and a considerable number of significant, but low-risk loci have been identified. In addition, several groups have analyzed PCa by determination of genomic copy number, fusion gene generation and targeted resequencing of candidate genes, as well as exome and whole genome sequencing. These initial studies have examined both primary and metastatic tumors as well as murine xenografts and identified somatic alterations in TP53 and other potential driver genes, and the disturbance of androgen response and cell cycle pathways. It is hoped that continued characterization of risk factors as well as gene mutation and misregulation in tumors will aid in understanding, diagnosing and better treating PCa.
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Affiliation(s)
- Michael Dean
- Cancer and Inflammation Program, National Cancer Institute, National Institutes of Health, Frederick, MD 21702, USA.
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Cybulski C, Wokołorczyk D, Kluźniak W, Jakubowska A, Górski B, Gronwald J, Huzarski T, Kashyap A, Byrski T, Dębniak T, Gołąb A, Gliniewicz B, Sikorski A, Switała J, Borkowski T, Borkowski A, Antczak A, Wojnar L, Przybyła J, Sosnowski M, Małkiewicz B, Zdrojowy R, Sikorska-Radek P, Matych J, Wilkosz J, Różański W, Kiś J, Bar K, Bryniarski P, Paradysz A, Jersak K, Niemirowicz J, Słupski P, Jarzemski P, Skrzypczyk M, Dobruch J, Domagała P, Narod SA, Lubiński J. An inherited NBN mutation is associated with poor prognosis prostate cancer. Br J Cancer 2012; 108:461-8. [PMID: 23149842 PMCID: PMC3566821 DOI: 10.1038/bjc.2012.486] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To establish the contribution of eight founder alleles in three DNA damage repair genes (BRCA1, CHEK2 and NBS1) to prostate cancer in Poland, and to measure the impact of these variants on survival among patients. METHODS Three thousand seven hundred fifty men with prostate cancer and 3956 cancer-free controls were genotyped for three founder alleles in BRCA1 (5382insC, 4153delA, C61G), four alleles in CHEK2 (1100delC, IVS2+1G>A, del5395, I157T), and one allele in NBS1 (657del5). RESULTS The NBS1 mutation was detected in 53 of 3750 unselected cases compared with 23 of 3956 (0.6%) controls (odds ratio (OR)=2.5; P=0.0003). A CHEK2 mutation was seen in 383 (10.2%) unselected cases and in 228 (5.8%) controls (OR=1.9; P<0.0001). Mutation of BRCA1 (three mutations combined) was not associated with the risk of prostate cancer (OR=0.9; P=0.8). In a subgroup analysis, the 4153delA mutation was associated with early-onset (age ≤ 60 years) prostate cancer (OR=20.3, P=0.004). The mean follow-up was 54 months. Mortality was significantly worse for carriers of a NBS1 mutation than for non-carriers (HR=1.85; P=0.008). The 5-year survival for men with an NBS1 mutation was 49%, compared with 72% for mutation-negative cases. CONCLUSION A mutation in NBS1 predisposes to aggressive prostate cancer. These data are relevant to the prospect of adapting personalised medicine to prostate cancer prevention and treatment.
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Affiliation(s)
- C Cybulski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University, ul. Połabska 4, Szczecin 70-115, Poland
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Bambury RM, Gallagher DJ. Prostate cancer: germline prediction for a commonly variable malignancy. BJU Int 2012; 110:E809-18. [PMID: 22974436 DOI: 10.1111/j.1464-410x.2012.11450.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
UNLABELLED What's known on the subject? and What does the study add? Prostate cancer is a heterogeneous disease and biomarkers to predict its incidence and subsequent clinical behaviour are needed to tailor screening, prevention and therapeutic strategies. Rare mutations in genes such as BRCA1, BRCA2 and HOXB13 can affect prostate cancer incidence and/or clinical behaviour. Genome wide association studies (GWAS) have identified more common genetic variations that explain an estimated 20% of familial prostate cancer risk. In this review, we focus on the potential of germline genetic variation to provide biomarkers for prostate cancer screening, prevention and management. We discuss how germline genetics may have a role in treatment selection if reliable pharmacogenetic predictors of efficacy and toxicity can be identified. We have outlined possible mechanisms for including germline investigation in future prostate cancer clinical trials. OBJECTIVES • Prostate cancer is a heterogeneous disease and biomarkers to predict its incidence and subsequent clinical behaviour are needed to tailor screening, prevention and therapeutic strategies. • In this review we focus on the potential of germline genetic variation to provide these biomarkers. METHODS • We review the published literature on germline genetics in prostate cancer and examine the possibility of including germline genetic biomarkers in future prostate cancer clinical trials. RESULTS • Rare mutations in genes such as BRCA1, BRCA2 and HOXB13 can affect prostate cancer incidence and/or clinical behaviour. • Genome-wide association studies (GWAS) have identified more common genetic variations that explain an estimated 20% of familial prostate cancer risk. • Germline genetics may have a role in treatment selection, if reliable pharmacogenetic predictors of efficacy and toxicity can be identified. CONCLUSION • This rapidly emerging area of prostate cancer research may provide answers to current clinical conundrums in the prostate cancer treatment paradigm. We have outlined possible mechanisms for including germline investigation in future prostate cancer clinical trial design.
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Affiliation(s)
- Richard M Bambury
- Department of Medical Oncology, Mater Misericordiae University Hospital and St James's Hospital, Dublin, Ireland.
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Do Breast Cancer Patients Tested in the Oncology Care Setting Share BRCA Mutation Results with Family Members and Health Care Providers? J Cancer Epidemiol 2012; 2012:498062. [PMID: 22848222 PMCID: PMC3403073 DOI: 10.1155/2012/498062] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 05/25/2012] [Indexed: 01/05/2023] Open
Abstract
BRCA genetic test results provide important information to manage cancer risk for patients and their families. Little is known on the communication of genetic test results by mutation status with family members and physicians in the oncology care setting. As part of a longitudinal study evaluating the impact of genetic counseling and testing among recently diagnosed breast cancer patients, we collected patients' self-reported patterns of disclosure. Descriptive statistics characterized the sample and determined the prevalence of disclosure of BRCA test results to family members and physicians. Of 100 patients who completed the baseline and the 6-month followup survey, 77 reported pursuing testing. The majority shared test results with female first-degree relatives; fewer did with males. Participants were more likely to share results with oncologists compared to surgeons, primary care physicians, or other specialty physicians. These findings suggest that while breast cancer patients may communicate results to at-risk female family members and their medical oncologist, they may need education and support to facilitate communication to other first-degree relatives and providers.
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Castro E, Eeles R. The role of BRCA1 and BRCA2 in prostate cancer. Asian J Androl 2012; 14:409-14. [PMID: 22522501 PMCID: PMC3720154 DOI: 10.1038/aja.2011.150] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 02/23/2012] [Indexed: 12/19/2022] Open
Abstract
One of the strongest risk factors for prostate cancer is a family history of the disease. Germline mutations in the breast cancer predisposition gene 2 (BRCA2) are the genetic events known to date that confer the highest risk of prostate cancer (8.6-fold in men ≤65 years). Although the role of BRCA2 and BRCA1 in prostate tumorigenesis remains unrevealed, deleterious mutations in both genes have been associated with more aggressive disease and poor clinical outcomes. The increasing incidence of prostate cancer worldwide supports the need for new methods to predict outcome and identify patients with potentially lethal forms of the disease. As we present here, BRCA germline mutations, mainly in the BRCA2 gene, are one of those predictive factors. We will also discuss the implications of these mutations in the management of prostate cancer and hypothesize on the potential for the development of strategies for sporadic cases with similar characteristics.
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Affiliation(s)
- Elena Castro
- Oncogenetics Team, The Institute of Cancer Research, Sutton, UK
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Amin S, McBride R, Kline J, Mitchel EB, Lucas AL, Neugut AI, Frucht H. Incidence of subsequent pancreatic adenocarcinoma in patients with a history of nonpancreatic primary cancers. Cancer 2012; 118:1244-51. [PMID: 21887676 PMCID: PMC3677019 DOI: 10.1002/cncr.26414] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Revised: 05/31/2011] [Accepted: 06/06/2011] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several environmental risk factors are known to predispose individuals to pancreatic cancer, and up to 15% of pancreatic cancers have an inherited component. Understanding metachronous cancer associations can modify pancreas cancer risk. The objective of this study was to investigate the association of nonpancreatic cancers with subsequent pancreatic adenocarcinoma. METHODS The authors used data from the US Surveillance, Epidemiology, and End Results (SEER) registries to identify 1,618,834 individuals who had a primary malignancy and subsequent pancreatic adenocarcinoma (n = 4013). Standardized incidence ratios were calculated as an approximation of relative risk (RR) for the occurrence of pancreatic adenocarcinoma after another primary malignancy. RESULTS Among patients who were diagnosed with a first primary malignancy at ages 20 to 49 years, the risk of subsequent pancreatic adenocarcinoma was increased among patients who had cancers of the ascending colon (relative risk [RR], 4.62; 95% confidence interval [CI], 1.86-9.52), hepatic flexure (RR, 5.42; 95% CI, 1.12-15.84), biliary system (RR, 13.14; 95% CI, 4.27-30.66), breast (RR, 1.32; 95% CI, 1.09-1.59), uterine cervix (RR, 1.61; 95% CI, 1.02-2.41), testes (RR, 2.78; 95% CI, 1.83-4.05), and hematopoietic system (RR, 1.83; 95% CI, 1.28-2.53). Among patients who had a first malignancy at ages 50 to 64 years, the risk was increased after cancers of the stomach (RR, 1.88; 95% CI, 1.13-2.93), hepatic flexure (RR, 2.25; 95% CI, 1.08-4.13), lung and bronchus (RR, 1.46; 95% CI, 1.16-1.82), pharynx (RR, 2.26; 95% CI, 1.13-4.04), and bladder (RR, 1.24; 95% CI, 1.03-1.48). Among patients who had a primary cancer after age 65 years, the risk was increased after cancers of the stomach (RR, 1.79; 95% CI, 1.23-2.53), hepatic flexure (RR, 1.76; 95% CI, 1.06-2.75), biliary system (RR, 2.35; 95% CI, 1.17-4.20), and uterus (RR, 1.23; 95% CI, 1.03-1.47). CONCLUSIONS The results from the current population-based data set suggested that pancreatic adenocarcinoma is associated with certain primary cancers. Genetic predisposition and common environmental and behavioral risk factors all may contribute to this observation. Specific tumor associations will guide future risk-stratification efforts.
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Affiliation(s)
- Sunil Amin
- College of Physicians and Surgeons, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Muzzi Mirza Pancreatic Cancer Prevention & Genetics Program, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
| | - Russell McBride
- Department of Epidemiology, Mailman School of Public Health
- Herbert Irving Comprehensive Cancer Center
| | - Jennie Kline
- Sergievsky Center, Columbia University, New York, NY and the New York State Psychiatric Institute, New York, NY
- Department of Epidemiology, Mailman School of Public Health
| | - Elana B. Mitchel
- College of Physicians and Surgeons, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Muzzi Mirza Pancreatic Cancer Prevention & Genetics Program, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
| | - Aimee L. Lucas
- Muzzi Mirza Pancreatic Cancer Prevention & Genetics Program, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Division of Digestive and Liver Diseases, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Department of Medicine, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
| | - Alfred I. Neugut
- Department of Medicine, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Herbert Irving Comprehensive Cancer Center
| | - Harold Frucht
- Muzzi Mirza Pancreatic Cancer Prevention & Genetics Program, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Division of Digestive and Liver Diseases, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Department of Medicine, Columbia University, New York, NY and New York Presbyterian Hospital, New York, NY
- Herbert Irving Comprehensive Cancer Center
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Fachal L, Gómez-Caamaño A, Celeiro-Muñoz C, Peleteiro P, Blanco A, Carballo A, Forteza J, Carracedo A, Vega A. BRCA1 mutations do not increase prostate cancer risk: results from a meta-analysis including new data. Prostate 2011; 71:1768-79. [PMID: 21520156 DOI: 10.1002/pros.21394] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 03/16/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although in recent years deleterious BRCA1 mutations have been extensively studied as a prostate cancer risk factor, results are inconclusive. To assess the contribution of the BRCA1 Galician founder mutation c.211A>G in prostate cancer morbidity we conducted a case-control study. Moreover, to better elucidate whether deleterious BRCA1 mutations are involved in the development of prostate cancer, we performed a systematic review and a meta-analysis of BRCA1 studies on prostate cancer. METHODS A total of 905 unselected men diagnosed with adenocarcinoma of the prostate and a control group of 936 unrelated men without history of prostate cancer were evaluated for c.211A>G. Adjusted by age Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using logistic regression. To construct the meta-analysis, genotype-based epidemiological studies reporting BRCA1 founder mutations on prostate cancer were identified by comprehensive and systematic bibliographic search. After extraction of relevant data, main and subgroup analysis by mutation were performed to assess the effect of BRCA1 on prostate cancer risk. RESULTS Four c.211A>G heterozygous individuals, one patient and three controls, were detected (OR = 0.27; 95% CI: 0.01-2.36; P = 0.28). Meta-analysis results from the integration of our data and other seven studies with BRCA1 genotyping data (5,705 prostate cancer cases and 13,218 controls) did not detect an association with prostate cancer risk (OR = 1.36; 95% CI: 0.87-2.14; P = 0.18). CONCLUSIONS Our conclusive trial demonstrates the lack of association between Galician splicing mutation c.211A>G in the BRCA1 gene and prostate cancer risk. Moreover, the result of the meta-analysis also discards the involvement of BRCA1 mutations in the development of prostate cancer.
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Affiliation(s)
- Laura Fachal
- Fundación Pública Galega de Medicina Xenómica-SERGAS. Grupo de Medicina Xenómica-USC, CIBERER, IDIS, Santiago de Compostela, Spain
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Thorne H, Willems AJ, Niedermayr E, Hoh IMY, Li J, Clouston D, Mitchell G, Fox S, Hopper JL, Bolton D. Decreased prostate cancer-specific survival of men with BRCA2 mutations from multiple breast cancer families. Cancer Prev Res (Phila) 2011; 4:1002-10. [PMID: 21733824 DOI: 10.1158/1940-6207.capr-10-0397] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The role of a germ-line BRCA2 mutation in the development of prostate cancer is established, but the clinical presentation linked to outcome for this group of men has not been well described. A total of 148 men from 1,423 families were ascertained from the kConFab consortium. Each participant met the following criteria: (i) a verified case of prostate cancer; (ii) confirmed as either a carrier or noncarrier of a family-specific BRCA pathogenic mutation; (iii) comprehensive clinical and treatment data were available. Clinical data were linked to treatment received and overall survival was analyzed by Kaplan-Meier. Prostate cancer in men from breast cancer-prone families has a high risk of disease progression, irrespective of mutation status. BRCA2 mutation carriers have an increased risk of death and prostate cancer-related death [HR (95% CI) 4.5 (2.12-9.52), P = 8.9 × 10(-5)] by comparison with noncarriers. Serum PSA readings taken prior to diagnosis in 90% of all men, age adjusted, were above clinical significance. Following D'Amico risk stratification, 77.5% of BRCA2 mutation carriers and 58.7% of noncarriers had high-risk disease. BRCA2 mutation status was also an independent prognostic indicator of overall survival. Furthermore, there was a poor overall survival outcome for both the BRCA2 mutation carriers and noncarriers given curative-intent treatment. All men in breast cancer-prone families are at risk of developing aggressive prostate cancer. This information is significant and should be included in discussions with genetic counselors and medical professionals when discussing prostate cancer treatment options for men in these families, irrespective of mutation status.
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Affiliation(s)
- Heather Thorne
- kConFab, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia, 3002.
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Mitra AV, Bancroft EK, Barbachano Y, Page EC, Foster CS, Jameson C, Mitchell G, Lindeman GJ, Stapleton A, Suthers G, Evans DG, Cruger D, Blanco I, Mercer C, Kirk J, Maehle L, Hodgson S, Walker L, Izatt L, Douglas F, Tucker K, Dorkins H, Clowes V, Male A, Donaldson A, Brewer C, Doherty R, Bulman B, Osther PJ, Salinas M, Eccles D, Axcrona K, Jobson I, Newcombe B, Cybulski C, Rubinstein WS, Buys S, Townshend S, Friedman E, Domchek S, Ramon Y Cajal T, Spigelman A, Teo SH, Nicolai N, Aaronson N, Ardern-Jones A, Bangma C, Dearnaley D, Eyfjord J, Falconer A, Grönberg H, Hamdy F, Johannsson O, Khoo V, Kote-Jarai Z, Lilja H, Lubinski J, Melia J, Moynihan C, Peock S, Rennert G, Schröder F, Sibley P, Suri M, Wilson P, Bignon YJ, Strom S, Tischkowitz M, Liljegren A, Ilencikova D, Abele A, Kyriacou K, van Asperen C, Kiemeney L, Easton DF, Eeles RA. Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study. BJU Int 2010; 107:28-39. [PMID: 20840664 DOI: 10.1111/j.1464-410x.2010.09648.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the role of targeted prostate cancer screening in men with BRCA1 or BRCA2 mutations, an international study, IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls), was established. This is the first multicentre screening study targeted at men with a known genetic predisposition to prostate cancer. A preliminary analysis of the data is reported. PATIENTS AND METHODS Men aged 40-69 years from families with BRCA1 or BRCA2 mutations were offered annual prostate specific antigen (PSA) testing, and those with PSA > 3 ng/mL, were offered a prostate biopsy. Controls were men age-matched (± 5 years) who were negative for the familial mutation. RESULTS In total, 300 men were recruited (205 mutation carriers; 89 BRCA1, 116 BRCA2 and 95 controls) over 33 months. At the baseline screen (year 1), 7.0% (21/300) underwent a prostate biopsy. Prostate cancer was diagnosed in ten individuals, a prevalence of 3.3%. The positive predictive value of PSA screening in this cohort was 47·6% (10/21). One prostate cancer was diagnosed at year 2. Of the 11 prostate cancers diagnosed, nine were in mutation carriers, two in controls, and eight were clinically significant. CONCLUSIONS The present study shows that the positive predictive value of PSA screening in BRCA mutation carriers is high and that screening detects clinically significant prostate cancer. These results support the rationale for continued screening in such men.
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Affiliation(s)
- Anita V Mitra
- The Institute of Cancer Research, Sutton, Surrey, UK
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Abstract
Hereditary breast and ovarian cancer due to mutations in the BRCA1 and BRCA2 genes is the most common cause of hereditary forms of both breast and ovarian cancer. The overall prevalence of BRCA1/2 mutations is estimated to be from 1 in 400 to 1 in 800 with a higher prevalence in the Ashkenazi Jewish population (1 in 40). Estimates of penetrance (cancer risk) vary considerably depending on the context in which they were derived and have been shown to vary within families with the same BRCA1/2 mutation. This suggests there is no exact risk estimate that can be applied to all individuals with a BRCA1/2 mutation. The likelihood of harboring a BRCA1 or BRCA2 mutation is dependent on one's personal and/or family history of cancer and can be estimated using various mutation probability models. For those individuals who have a BRCA1 or BRCA2 mutation, several screening and primary prevention options have been suggested, including prophylactic surgery and chemoprevention. Once a BRCA1 or BRCA2 mutation has been identified in a family, testing of at-risk relatives can identify those family members who also have the familial mutation and thus need increased surveillance and early intervention when a cancer is diagnosed.
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The rs1447295 and DG8S737 markers on chromosome 8q24 and cancer risk in the Polish population. Eur J Cancer Prev 2010; 19:167-71. [PMID: 19952762 DOI: 10.1097/cej.0b013e32832945c3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Several recent association studies implicate three neighbouring regions of chromosome 8q24 as the site of prostate cancer susceptibility loci. One region contains both a microsatellite marker DG8S737 and a single nucleotide polymorphism rs1447295. Both have been consistently associated with prostate cancer risk in several populations. However, studies to date have not inquired whether the susceptibility associated with this particular region of 8q24 extends to other cancer sites. We genotyped 3822 cases of cancer of various sites and 1807 controls for rs1447295 polymorphism. A positive association was seen for prostate cancer, but not for any of the other sites studied [odds ratios (ORs) ranging from 0.8 to 1.1]. Prostate cancer cases and controls were genotyped for both rs1447285 and DG8S737. Significant ORs were observed for the A allele of rs1447285 (OR = 1.4; P = 0.01) and the -8 allele of DG8S737 (OR = 1.6; P = 0.006). The association was particularly strong for men with familial prostate cancer (OR = 2.0, P = 0.004 for the A allele; OR = 3.5, P<0.0001 for the -8 allele). The OR associated with the A allele of rs1447295 was slightly higher for aggressive tumours (Gleason score 8 or more) (OR = 1.5), than for tumours with Gleason score 7 and below (OR = 1.3). In conclusion, the relationship between the rs1447295 and DG8S737 polymorphic variants on chromosome 8q24 and prostate cancer risk is seen in the Polish population to a similar degree as it has been observed elsewhere. Although the carcinogenic mechanism associated with this particular locus of 8q24 is unclear it appears to be specific to prostate cancer.
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Gallagher DJ, Gaudet MM, Pal P, Kirchhoff T, Balistreri L, Vora K, Bhatia J, Stadler Z, Fine SW, Reuter V, Zelefsky M, Morris MJ, Scher HI, Klein RJ, Norton L, Eastham JA, Scardino PT, Robson ME, Offit K. Germline BRCA mutations denote a clinicopathologic subset of prostate cancer. Clin Cancer Res 2010; 16:2115-21. [PMID: 20215531 DOI: 10.1158/1078-0432.ccr-09-2871] [Citation(s) in RCA: 205] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE Increased prostate cancer risk has been reported for BRCA mutation carriers, but BRCA-associated clinicopathologic features have not been clearly defined. EXPERIMENTAL DESIGN We determined BRCA mutation prevalence in 832 Ashkenazi Jewish men diagnosed with localized prostate cancer between 1988 and 2007 and 454 Ashkenazi Jewish controls and compared clinical outcome measures among 26 BRCA mutation carriers and 806 noncarriers. Kruskal-Wallis tests were used to compare age of diagnosis and Gleason score, and logistic regression models were used to determine associations between carrier status, prostate cancer risk, and Gleason score. Hazard ratios (HR) for clinical end points were estimated using Cox proportional hazards models. RESULTS BRCA2 mutations were associated with a 3-fold risk of prostate cancer [odds ratio, 3.18; 95% confidence interval (95% CI), 1.52-6.66; P = 0.002] and presented with more poorly differentiated (Gleason score > or =7) tumors (85% versus 57%; P = 0.0002) compared with non-BRCA-associated prostate cancer. BRCA1 mutations conferred no increased risk. After 7,254 person-years of follow-up, and adjusting for clinical stage, prostate-specific antigen, Gleason score, and treatment, BRCA2 and BRCA1 mutation carriers had a higher risk of recurrence [HR (95% CI), 2.41 (1.23-4.75) and 4.32 (1.31-13.62), respectively] and prostate cancer-specific death [HR (95% CI), 5.48 (2.03-14.79) and 5.16 (1.09-24.53), respectively] than noncarriers. CONCLUSIONS BRCA2 mutation carriers had an increased risk of prostate cancer and a higher histologic grade, and BRCA1 or BRCA2 mutations were associated with a more aggressive clinical course. These results may have implications for tailoring clinical management of this subset of hereditary prostate cancer.
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Affiliation(s)
- David J Gallagher
- Clinical Genetics Service, Department of Medicine, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Grindedal EM, Møller P, Eeles R, Stormorken AT, Bowitz-Lothe IM, Landrø SM, Clark N, Kvåle R, Shanley S, Maehle L. Germ-line mutations in mismatch repair genes associated with prostate cancer. Cancer Epidemiol Biomarkers Prev 2009; 18:2460-7. [PMID: 19723918 DOI: 10.1158/1055-9965.epi-09-0058] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Genetic predisposition to prostate cancer includes multiple common variants with a low penetrance (single nucleotide polymorphisms) and rare variants with higher penetrance. The mismatch repair (MMR) genes MLH1, MSH2, MSH6, and PMS2 are associated with Lynch syndrome where colon and endometrial cancers are the predominant phenotypes. The purpose of our study was to investigate whether germ-line mutations in these genes may be associated with prostate cancer. One hundred and six male carriers or obligate carriers of MMR mutations were identified. Nine had contracted prostate cancer. Immunohistochemical analysis was done on tumor tissue from eight of the nine tumors. Observed incidence, cumulative risk at 60 and 70 years of age, age of onset, and Gleason score were compared with expected as assessed from population-based series. Absence of gene product from the mutated MMR gene was found in seven of eight tumors. Expected number of prostate cancers was 1.52 compared with 9 observed (P < 0.01). Mean age of onset of prostate cancer was 60.4 years compared with 66.6 expected (P = 0.006); the number of men with a Gleason score between 8 and 10 was significantly higher than expected (P < 0.00001). Kaplan-Meier analysis suggested that cumulative risk by 70 years in MMR mutation carriers may be 30% (SE, 0.088) compared with 8.0% in the general population. This is similar to the high risk associated with BRCA2 mutations. To our knowledge, this study is the first to indicate that the MMR genes may be among the rare genetic variants that confer a high risk of prostate cancer when mutated.
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Affiliation(s)
- Eli Marie Grindedal
- Section for Inherited Cancer, Department of Medical Genetics, Rikshospitalet University Hospital, N-0310 Oslo, Norway
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Agalliu I, Gern R, Leanza S, Burk RD. Associations of high-grade prostate cancer with BRCA1 and BRCA2 founder mutations. Clin Cancer Res 2009; 15:1112-20. [PMID: 19188187 PMCID: PMC3722558 DOI: 10.1158/1078-0432.ccr-08-1822] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Protein-truncating mutations in BRCA1 and in particular BRCA2 genes have been associated with prostate cancer. However, there is still uncertainty about the magnitude of association particularly with Gleason score, and family history of prostate, breast, and ovary cancers. EXPERIMENTAL DESIGN To further examine associations between three founder mutations located in BRCA1 (185delAG, 5382insC) or BRCA2 (6174delT) genes and prostate cancer, we conducted a study of 979 prostate cancer cases and 1,251 controls among Ashkenazi Jewish men. Detailed information was obtained on prostate cancer pathology, age at diagnosis, and family history of all cancers. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using logistic regression models. RESULTS Prostate cancer risk was increased (OR, 1.9; 95% CI 0.9-4.1) for BRCA2 mutation carriers but not for BRCA1 mutation carriers. BRCA2 mutation carriers had an OR of 3.2 (95% CI, 1.4-7.3) for Gleason score of 7 to 10, but no association was observed for Gleason score of < 7. Carriers of BRCA1-185delAG mutation also had an OR of 3.5 (95% CI, 1.2-10.3) for Gleason score of > or =7 tumors; however, the association of either BRCA1-185delAG or 5382insC mutation was not statistically significant. Associations between founder mutations and prostate cancer were stronger in men with no first-degree family history of breast and/or ovarian cancers but were unaffected by family history of prostate cancer. CONCLUSION These results indicate that the BRCA2 founder mutation confers a 3-fold elevated risk of high-grade prostate cancer. Although BRCA1 mutations were not associated with prostate cancer, the BRCA1-185delAG was associated with high Gleason score tumors. These findings should be carefully considered in genetic counseling and/or evaluating therapeutic options.
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Affiliation(s)
- Ilir Agalliu
- Department of Epidemiology Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Robert Gern
- Department of Epidemiology Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Suzanne Leanza
- Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, New York
| | - Robert D. Burk
- Department of Epidemiology Population Health, Albert Einstein College of Medicine, Bronx, New York
- Department of Pediatrics (Genetics), Albert Einstein College of Medicine, Bronx, New York
- Department of Microbiology and Immunology, and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York
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Majdak-Paredes E, Fatah F. Hereditary breast cancer syndromes and clinical implications. J Plast Reconstr Aesthet Surg 2009; 62:181-9. [DOI: 10.1016/j.bjps.2008.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Revised: 06/09/2008] [Accepted: 07/01/2008] [Indexed: 11/30/2022]
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Ostrander EA, Udler MS. The role of the BRCA2 gene in susceptibility to prostate cancer revisited. Cancer Epidemiol Biomarkers Prev 2008; 17:1843-8. [PMID: 18708369 DOI: 10.1158/1055-9965.epi-08-0556] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer is a genetically complex disease with multiple predisposing factors affecting presentation, progression, and outcome. Epidemiologic studies have long shown an aggregation of breast and prostate cancer in some families. More recently, studies have reported an apparent excess of prostate cancer cases among BRCA2 mutation-carrying families. Additionally, population-based screens of early-onset prostate cancer patients have suggested that the prevalence of deleterious BRCA2 mutations in this group is 1% to 2%, imparting a significantly increased risk of the disease compared with noncarrier cases. However, studies of high-risk prostate cancer families suggest that BRCA2 plays at most a minimal role in these individuals, highlighting the potential genetic heterogeneity of the disease. In this commentary, we review the current literature and hypotheses surrounding the relationship between BRCA2 mutations and susceptibility to prostate cancer and speculate on the potential for involvement of additional genes.
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Affiliation(s)
- Elaine A Ostrander
- Cancer Genetic Branch, National Human Genome Research Institute, NIH, Room 52451, Building 50, Bethesda, MD 20892, USA.
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