Ovacome Summer 2014

ask the doctor
It’s not over yet, though. AstraZeneca continues with
its confirmatory Phase III study of the PARP inhibitor,
SOLO-2. And the R&D group will need to report clear
signs of a benefit to get this drug to the U.S. market.
In Europe, AstraZeneca is hoping for a smoother journey.
It goes without saying that we want to get Olaparib
available in clinical practice as soon as possible.
Do you think that all women
with ovarian cancer should be
BRCA tested now and ask for
the test at their hospital?
It looks like Olaparib could make a significant impact on
the treatment of late stage ovarian cancer. That’s why
we are hoping that everyone will be offered testing at
diagnosis: as a first step with blood and eventually with
tissue. We want this so that we can see which women will
benefit from Olaparib.
I think BRCA should be more widely available to other
women too who might not necessarily have a strong case
with regard to their family history, but could well benefit.
I’m thinking of, for instance, a woman in her early 30s
who has triple negative breast cancer. Even if she doesn’t
have a strong family history, there is still a reasonably
high risk of her having the BRCA1 or BRCA2 fault and
so she will be at high risk of developing ovarian cancer. It
would be a nightmare to get through breast cancer only to
develop ovarian cancer in her early 40s when this could
be avoided.
Should a positive BRCA test
always lead to a recommendation
for preventative treatment?
JM: If, say, a patient is found to be BRCA positive and she
has an 18–year-old daughter, would we recommend having her
daughter tested? I would question that as she might have 22 years
ahead of her before she decided to have her ovaries removed
Photography by Tony Larkin/Rex Features.
Hollywood actress Angelina Jolie has already shone the spotlight on the
importance of high-risk women knowing their BRCA status.
in her early 40s after having a family. This might be different,
of course, if the daughter had breast cancer. A lot depends too
on the clinical context and such matters should always be the
patient’s decision rather than having rules about it.
This piece has been reviewed by
Chris Jacobs, consultant genetic
counsellor and joint lead for cancer
genetics clinical genetics department at
Guy’s Hospital, London.
She says: The article mentions that standard
NHS BRCA1 and BRCA2 genetic testing
gives one in 10 people an inconclusive result,
whereas private testing via the company
Myriad Genetics gives inconclusive results
to around one in 100 tests. This difference
is likely to be due to the greater number of
tests undertaken by Myriad genetics than
the NHS laboratories which enables them to
classify more inconclusive resuts as cancer
causing (pathogenic) or non-cancer causing
(non pathogenic). If all laboratories, including
private genetic testing companies, were to share
this type of data, it would enable all BRCA1/2
genetic testing to improve.
The article mentions that genetic testing
should be more widely available and gives an
example of a woman in her early 30s with
triple negative breast cancer and no cancer
family history. The NICE guidelines for
familial breast cancer, which were published
in June 2013, recommended that BRCA1
and BRCA2 genetic testing is offered to any
woman in England and Wales with at least a
10% chance of a fault in one of these genes.
This would include women with ovarian cancer
and women with triple negative breast cancer
who are diagnosed at a young age and have no
family history of the disease. Women in this
situation can be referred to their local regional
genetics service to discuss genetic testing.
it together
Phone Ovacome’s nurse led support line on 0845 371 0554 7