Khokhlova S.V., Gorbunova V.A., Lyubchenko L.N., Imyanitov E.N. BRCA-associated ovarian cancer (the experience of the Chemotherapy Department in N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of Russia). Journal of Modern Oncology. 2016; 18 (1): 37–44.
BRCA-ассоциированный рак яичников (опыт отделения химиотерапии ФГБУ «РОНЦ им. Н.Н.Блохина» Минздрава России)
Khokhlova S.V., Gorbunova V.A., Lyubchenko L.N., Imyanitov E.N. BRCA-associated ovarian cancer (the experience of the Chemotherapy Department in N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of Russia). Journal of Modern Oncology. 2016; 18 (1): 37–44.
В последние годы основные научные направления при раке яичников связаны с попыткой индивидуализации лечения на основании молекулярно-биологических прогностических и предиктивных маркеров. В 10–15% случаев в возникновении рака яичников участвуют нарушения в генах BRCA1 и BRCA2. Главной функцией комплекса белков BRCA является регуляция восстановления двунитевых разрывов ДНК по механизму гомологичной рекомбинации. Результатом дисфункции BRCA может быть нарушение BRCA-ассоциированного механизма репарации ДНК. Как следствие, эти опухоли могут быть чрезвычайно чувствительны к ДНК-повреждающим цитостатикам – производным платины. Несколько исследований докладывает о лучшей выживаемости пациенток с наличием мутаций в генах BRCA, по сравнению со спорадическим раком яичников. Данные об особенностях течения и лечения больных раком яичников с наличием мутаций в генах BRCA1, 2 в российской популяции больных крайне скудны.
In recent years, the main scientific directions concerning ovarian cancer have been associated with the attempt to individualize the treatment based on prognostic and predictive molecular biological markers. The damage in BRCA1 and BRCA2 genes is identified in 10–15% of ovarian cancer cases. The main function of BRCA proteins is responsibility for repairing double-strand break in DNA by a mechanism of homologous recombination. The result of BRCA gene dysfunction is BRCA-associated DNA damage repair mechanism. As a result, these tumors can be extremely sensitive to DNA-damaging cytostatic agents – such as platinum-based drugs. Several studies show the better survival rates of patients with BRCA mutations in comparison with sporadic ovarian cancer. The information concerning the course of disease and treatment characteristics of patients with ovarian cancer associated with BRCA1, 2 mutations in the Russian population of patients is extremely limited.
1. Давыдов М.И., Аксель Е.М. Статистика злокачественных новообразований в России и странах СНГ в 2012 г. Вестн. Российского онкологического научного центра им. Н.Н.Блохина РАМН. 2013; 22 (3): 9–142. / Davydov M.I., Aksel' E.M. Statistika zlokachestvennykh novoobrazovanii v Rossii i stranakh SNG v 2012 g. Vestn. Rossiiskogo onkologicheskogo nauchnogo tsentra im. N.N.Blokhina RAMN. 2013; 22 (3): 9–142. [in Russian]
2. Имянитов Е.Н. Общие представления о наследственных опухолевых синдромах. Практическая онкология. 2014; 15 (3): 101. / Imianitov E.N. Obshchie predstavleniia o nasledstvennykh opukholevykh sindromakh. Prakticheskaia onkologiia. 2014; 15 (3): 101. [in Russian]
3. Максимов С.Я., Имянитов Е.Н. и др. Клинические особенности BRCA-позитивного рака яичников. Сиб. онкологический журн. 2013; 6 (60). / Maksimov S.Ia., Imianitov E.N. i dr. Klinicheskie osobennosti BRCA-pozitivnogo raka iaichnikov. Sib. onkologicheskii zhurn. 2013; 6 (60). [in Russian]
4. Мамедов В.А., Бахидзе Е.В., Имянитов Е.Н. Оценка эффективности лекарственного лечения у больных раком яичников с различным статусом гена BRCA. Сиб. онкологический журн. 2009; S1: 129–30. / Mamedov V.A., Bakhidze E.V., Imianitov E.N. Otsenka effektivnosti lekarstvennogo lecheniia u bol'nykh rakom iaichnikov s razlichnym statusom gena BRCA. Sib. onkologicheskii zhurn. 2009; S1: 129–30. [in Russian]
5. Смирнова Т.Ю., Поспехова Н.И., Любченко Л.Н. и др. Высокая частота мутаций в генах BRCA1 и BRCA2 при раке. Бюлл. эксперимент. биологии и медицины. 2007; 144 (7): 93–5. / Smirnova .Iu., Pospekhova N.I., Liubchenko L.N. i dr. Vysokaia chastota mutatsii v genakh BRCA1 i BRCA2 pri rake. Biull. eksperiment. biologii i meditsiny. 2007; 144 (7): 93–5. [in Russian]
6. Fedorova OE, Liubchenko LN, Paiadini IuG et al. Analysis of BRCA1/2 and CHEK2 mutations in ovarian cancer and priary multiple tumors involving the ovaries. Patients of Russian population using biochips. Mol Biol (Mosk) 2007; 41: 37.
7. Imyanitov EN, Byrski T. Systemic treatment for hereditary cancers: a 2012 update. Hered Cancer Clin Pract 2013; 11 (1): 2. doi: 10.1186/1897-4287-11-2.
8. Imyanitov EN. Ovarian cancer genome. Methods Mol Biol 2013; 1049: 3–7.
9. Imyanitov EN, Moiseyenko V.M. Drug therapy for hereditary cancers. Hered Cancer Clin Pract 2011; 9 (1): 5. doi: 10.1186/1897-4287-9-5.
10. Armstrong DK et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. New En J Med 2006; 354 (1): 34–43.
11. Bolton K, Chenevix-Trench G et al. Association between BRCA1 and BRCA2 Mutations and Survival in women with Invasive Epithelial Ovarian Cancer. JAMA 2012; 307 (4): 382–90.
12. Boyd J, Sonoda Y, Federici MG et al. Clinicopathologic features of BRCA-linked and sporadic ovarian cancer. JAMA 2000; 283 (17): 2260–5.
13. Cass I, Baldwin R et al. Improved Survival in women with BRCA-associated Ovarian carcinoma. Am Cancer Soc 2003; 97 (9).
14. Chan JK, Tian C, Monk BJ et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer 2008; 112 (10: 2202–10.
15. Deng CX, Brodie SG. Role of BRCA 1 and its interacting proteins. Bioessays 2010; 22 (8): 728–37.
16. Farmer H, McCabe N, Lord CJ et al. Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 2005; 434 (7035): 917–21.
17. Karami F, Mehdipour P. A comprehensive focus on global spectrum of BRCA1 and BRCA2 mutations in breast cancer. Biomed Res Int 2013; c. 928562.
18. Lesnock JL et al. BRCA1 expression and improved survival in ovarian cancer patients treated with intraperitoneal cisplatin and paclitaxel: a Gynecologic Oncology Group Study. Br J Cancer 2013; 108 (6): 1231–7.
19. Leunen K et al. Does paclitaxel-carboplatin chemotherapy in a dose-dense regimen enhance survival of BRCA-related ovarian cancer patients? Intl J Gynecologic Cancer 2009; 19 (9): 1501–4.
20. Parvin JD. BRCA 1 at a branch point. Proc Natl Acad Dci USA 2001; 98 (11): 5952–4.
21. Rubin SC, Benjamin I, Behbakht K et al. Clinical and pathological features of ovarian cancer in women with germ-line mutations of BRCA1. N Engl J Med 1996; 335 (19): 1413–6.
22. Safra T, Rogowski O, Muggia FM. The effect of germ-line BRCA mutations on response to chemotherapy and outcome of recurrent ovarian cancer. Int J Gynecologic Cancer 2014; 24 (3): 488–95.
23. Yang D. Association of BRCA1 and BRCA2 mutations with survival, chemotherapy sensitivity, and gene mutator phenotype in patients with ovarian cancer. JAMA 2011; 306 (14): 1557–65.
24. Yang D, Khan S, Sun Y et al. Association between BRCA2 but not BRCA1 mutations and beneficial Survival, Chemotherapy sensitivy, and gene Mutator Phenotype in Patients with ovarian cancer. JAMA 2011; 306 (14): 1557–65.
25. Zhong Q, Peng H et al. Effects of BRCA1-and BRCA2-related Mutations on Ovarian and Breast Cancer Survival: A Meta-analysis. Clin Cancer Res 2014; 21 (1): 211–20.
26. Ashworth A et al. A synthetic lethal therapeutic approach: poly(ADP) ribose polymerase inhibitors for the treatment of cancers deficient in DNA double-strand break repair. J Clin Oncol 2008; 26: 3785–90.
27. McCabe N, Turner NC, Lord CJ et al. Deficiency in the repair of DNA damage by homologous recombination and sensitivity to Poly(ADP-Ribose) polymerase inhibition. Cancer Res 2006; 66: 8109–15.
28. Audeh MW et al. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial. Lancet 2010; 376: 245–51.
29. Ledermann J, Harter P. Olaparib maintenance therapy in patients with platinum- sensitive relapsed serous ovarian cancer: a preplanned retrospective analysis of outcomes by BRCA status in a randomised phase 2 trial. Lancel. Published Online May 30, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)70228-1
________________________________________________
1. Davydov M.I., Aksel' E.M. Statistika zlokachestvennykh novoobrazovanii v Rossii i stranakh SNG v 2012 g. Vestn. Rossiiskogo onkologicheskogo nauchnogo tsentra im. N.N.Blokhina RAMN. 2013; 22 (3): 9–142. [in Russian]
2. Imianitov E.N. Obshchie predstavleniia o nasledstvennykh opukholevykh sindromakh. Prakticheskaia onkologiia. 2014; 15 (3): 101. [in Russian]
3. Maksimov S.Ia., Imianitov E.N. i dr. Klinicheskie osobennosti BRCA-pozitivnogo raka iaichnikov. Sib. onkologicheskii zhurn. 2013; 6 (60). [in Russian]
4. Mamedov V.A., Bakhidze E.V., Imianitov E.N. Otsenka effektivnosti lekarstvennogo lecheniia u bol'nykh rakom iaichnikov s razlichnym statusom gena BRCA. Sib. onkologicheskii zhurn. 2009; S1: 129–30. [in Russian]
5. Smirnova .Iu., Pospekhova N.I., Liubchenko L.N. i dr. Vysokaia chastota mutatsii v genakh BRCA1 i BRCA2 pri rake. Biull. eksperiment. biologii i meditsiny. 2007; 144 (7): 93–5. [in Russian]
6. Fedorova OE, Liubchenko LN, Paiadini IuG et al. Analysis of BRCA1/2 and CHEK2 mutations in ovarian cancer and priary multiple tumors involving the ovaries. Patients of Russian population using biochips. Mol Biol (Mosk) 2007; 41: 37.
7. Imyanitov EN, Byrski T. Systemic treatment for hereditary cancers: a 2012 update. Hered Cancer Clin Pract 2013; 11 (1): 2. doi: 10.1186/1897-4287-11-2.
8. Imyanitov EN. Ovarian cancer genome. Methods Mol Biol 2013; 1049: 3–7.
9. Imyanitov EN, Moiseyenko V.M. Drug therapy for hereditary cancers. Hered Cancer Clin Pract 2011; 9 (1): 5. doi: 10.1186/1897-4287-9-5.
10. Armstrong DK et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. New En J Med 2006; 354 (1): 34–43.
11. Bolton K, Chenevix-Trench G et al. Association between BRCA1 and BRCA2 Mutations and Survival in women with Invasive Epithelial Ovarian Cancer. JAMA 2012; 307 (4): 382–90.
12. Boyd J, Sonoda Y, Federici MG et al. Clinicopathologic features of BRCA-linked and sporadic ovarian cancer. JAMA 2000; 283 (17): 2260–5.
13. Cass I, Baldwin R et al. Improved Survival in women with BRCA-associated Ovarian carcinoma. Am Cancer Soc 2003; 97 (9).
14. Chan JK, Tian C, Monk BJ et al. Prognostic factors for high-risk early-stage epithelial ovarian cancer: a Gynecologic Oncology Group study. Cancer 2008; 112 (10: 2202–10.
15. Deng CX, Brodie SG. Role of BRCA 1 and its interacting proteins. Bioessays 2010; 22 (8): 728–37.
16. Farmer H, McCabe N, Lord CJ et al. Targeting the DNA repair defect in BRCA mutant cells as a therapeutic strategy. Nature 2005; 434 (7035): 917–21.
17. Karami F, Mehdipour P. A comprehensive focus on global spectrum of BRCA1 and BRCA2 mutations in breast cancer. Biomed Res Int 2013; c. 928562.
18. Lesnock JL et al. BRCA1 expression and improved survival in ovarian cancer patients treated with intraperitoneal cisplatin and paclitaxel: a Gynecologic Oncology Group Study. Br J Cancer 2013; 108 (6): 1231–7.
19. Leunen K et al. Does paclitaxel-carboplatin chemotherapy in a dose-dense regimen enhance survival of BRCA-related ovarian cancer patients? Intl J Gynecologic Cancer 2009; 19 (9): 1501–4.
20. Parvin JD. BRCA 1 at a branch point. Proc Natl Acad Dci USA 2001; 98 (11): 5952–4.
21. Rubin SC, Benjamin I, Behbakht K et al. Clinical and pathological features of ovarian cancer in women with germ-line mutations of BRCA1. N Engl J Med 1996; 335 (19): 1413–6.
22. Safra T, Rogowski O, Muggia FM. The effect of germ-line BRCA mutations on response to chemotherapy and outcome of recurrent ovarian cancer. Int J Gynecologic Cancer 2014; 24 (3): 488–95.
23. Yang D. Association of BRCA1 and BRCA2 mutations with survival, chemotherapy sensitivity, and gene mutator phenotype in patients with ovarian cancer. JAMA 2011; 306 (14): 1557–65.
24. Yang D, Khan S, Sun Y et al. Association between BRCA2 but not BRCA1 mutations and beneficial Survival, Chemotherapy sensitivy, and gene Mutator Phenotype in Patients with ovarian cancer. JAMA 2011; 306 (14): 1557–65.
25. Zhong Q, Peng H et al. Effects of BRCA1-and BRCA2-related Mutations on Ovarian and Breast Cancer Survival: A Meta-analysis. Clin Cancer Res 2014; 21 (1): 211–20.
26. Ashworth A et al. A synthetic lethal therapeutic approach: poly(ADP) ribose polymerase inhibitors for the treatment of cancers deficient in DNA double-strand break repair. J Clin Oncol 2008; 26: 3785–90.
27. McCabe N, Turner NC, Lord CJ et al. Deficiency in the repair of DNA damage by homologous recombination and sensitivity to Poly(ADP-Ribose) polymerase inhibition. Cancer Res 2006; 66: 8109–15.
28. Audeh MW et al. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and recurrent ovarian cancer: a proof-of-concept trial. Lancet 2010; 376: 245–51.
29. Ledermann J, Harter P. Olaparib maintenance therapy in patients with platinum- sensitive relapsed serous ovarian cancer: a preplanned retrospective analysis of outcomes by BRCA status in a randomised phase 2 trial. Lancel. Published Online May 30, 2014 http://dx.doi.org/10.1016/ S1470-2045(14)70228-1
1 ФГБУ Российский онкологический научный центр им. Н.Н.Блохина Минздрава России. 115478, Россия, Москва, Каширское ш., д. 23;
2 ФГБУ Научно-исследовательский институт онкологии им. Н.Н.Петрова Минздрава России. 197758, Россия, Санкт-Петербург, пос. Песочный, ул. Ленинградская, д. 68
*SVKhokhlova@mail.ru
1 N.N.Blokhin Russian Cancer Research Center of the Ministry of Health of the Russian Federation. 115478, Russian Federation, Moscow, Kashirskoe sh., d. 23;
2 N.N.Petrov Research Institute of Oncology of the Ministry of Health of the Russian Federation. 197758, Russian Federation, Saint Petersburg, pos. Pesochnyi, ul. Leningradskaia, d. 68
*SVKhokhlova@mail.ru