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BRCA Gene Mutations and Ovarian Cancer The connection between BRCA genes and ovarian cancer has been documented in the past. Normal BRCA genes monitor cell growth and function as DNA "repairmen," correcting damaged DNA. If the BRCA gene mutates (most often into BRCA1 or BRCA2) this ability if lost and the risk of developing either breast or ovarian cancer increases. Women with BRCA mutations have a 16 to 44 percent chance of developing ovarian tumors. However, research has also revealed that women carrying BRCA mutations, while more susceptible to ovarian cancer, also tend to have longer survival rates, and an overall better prognosis than those who don't. This has puzzled medical researchers for some time. A report published in the 2003 edition of Cancer sheds some light on this puzzle. A study at the Cedars-Sinai Medical Center in Los Angeles suggests that the very gene mutations that cause ovarian cancer in some women may make them respond better to platinum-based chemotherapy. Askenazi Jews and BRCA The participants for the study were chosen from among Askenazi Jewish women, a cultural group with an unusually high rate of BRCA mutation. Two percent of all Askenazi women have abnormal BRCA genes, most often BRCA1. Of the 71 women selected for the study, 34 carried mutated forms of BRCA , while the remainder had no evidence of the mutation. All the women selected had ovarian cancer and all underwent chemotherapy treatment for their illness. Three factors were used to determine how well the women responded to chemotherapy. A post-treatment surgical examination was one, and tumor size measured to record any signs of size reduction was a second. Finally, the study identified participants who presented disease-free after five years. Survival rates for the women with the BRCA mutation were noticeably higher than for those without the mutation. One year after treatment, one hundred percent of the BRCA mutation group survived, as opposed 83 percent of the women with normal BRCA genes. As time passed, the difference in survival rates became even more pronounced: after two to five years, 65 percent of the BRCA group survived, as opposed to only 43 percent of the other group. From the data accumulated during the study, it became obvious that women with BRCA genetic mutations responded better to chemotherapy than those without. Dr. Beth Karlan, one of the study authors, had this to say about the results: "The significantly longer survival of patients with BRCA-associated ovarian cancers in our study points to an enhanced tumor responsiveness to platinum-based chemotherapy, rather than less aggressive disease. Knowing how BRCA mutations increase response to treatment may lead to the development of targeted therapies or drugs that will improve survival for all women with ovarian cancer and point to novel means of cancer prevention." Resources Newswise.com. (2003). BRCA-mutations and ovarian cancer patients. Retrieved May 13, 2003, from www.newswise.com/articles/2003/5/BRCA.CED.html. Reuters Health Information. (2003). Women with BRCA gene have better chemo response. Retrieved May 13, 2003, from www.nlm.nih.gov/medlineplus/news/fullstory_12581.html.

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