Prostate cancer risk, screening and management in patients with germline BRCA1/2 mutations

Mutations in the BRCA1 and BRCA2 tumour suppressor genes are associated with prostate cancer risk; however, optimal screening protocols for individuals with these mutations have been a subject of debate. Several prospective studies of prostate cancer incidence and screening among BRCA1/2 mutation ca...

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Veröffentlicht in:Nature reviews. Urology Jg. 20; H. 4; S. 205 - 216
Hauptverfasser: Rajwa, Pawel, Quhal, Fahad, Pradere, Benjamin, Gandaglia, Giorgio, Ploussard, Guillaume, Leapman, Michael S, Gore, John L, Paradysz, Andrzej, Tilki, Derya, Merseburger, Axel S, Morgan, Todd M, Briganti, Alberto, Palapattu, Ganesh S, Shariat, Shahrokh F
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Nature Publishing Group 01.04.2023
Schlagworte:
BRCA1 Protein - genetics
BRCA2 Protein - genetics
Early Detection of Cancer - methods
Genes, BRCA1
Genetic Predisposition to Disease
Germ Cells - pathology
Humans
Male
Medical screening
Mutation
Prospective Studies
Prostate cancer
Prostate-Specific Antigen - genetics
Prostatic Neoplasms - diagnosis
Prostatic Neoplasms - genetics
Prostatic Neoplasms - therapy
Quality of Life
ISSN:1759-4812, 1759-4820, 1759-4820
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Zusammenfassung:Mutations in the BRCA1 and BRCA2 tumour suppressor genes are associated with prostate cancer risk; however, optimal screening protocols for individuals with these mutations have been a subject of debate. Several prospective studies of prostate cancer incidence and screening among BRCA1/2 mutation carriers have indicated at least a twofold to fourfold increase in prostate cancer risk among carriers of BRCA2 mutations compared with the general population. Moreover, BRCA2 mutations are associated with more aggressive, high-grade disease characteristics at diagnosis, more aggressive clinical behaviour and greater prostate cancer-specific mortality. The risk for BRCA1 mutations seems to be attenuated compared with BRCA2. Prostate-specific antigen (PSA) measurement or prostate magnetic resonance imaging (MRI) alone is an imperfect indicator of clinically significant prostate cancer; therefore, BRCA1/2 mutation carriers might benefit from refined risk stratification strategies. However, the long-term impact of prostate cancer screening is unknown, and the optimal management of BRCA1/2 carriers with prostate cancer has not been defined. Whether timely localized therapy can improve overall survival in the screened population is uncertain. Long-term results of prospective studies are awaited to confirm the optimal screening strategies and benefits of prostate cancer screening among BRCA1/2 mutation carriers, and whether these approaches ultimately have a positive impact on survival and quality of life in these patients.
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ISSN:1759-4812
1759-4820
1759-4820
DOI:10.1038/s41585-022-00680-4