SEATTLE — Even though half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, the implications for their health tend to be under-recognized compared to females, according to a new study.
The report in JAMA Oncology noted that germline variants in BRCA1 and BRCA2 (also known as pathogenic or likely pathogenic variants, referred to here as BRCA1/2 PVs) are understood to significantly increase the risk of breast and ovarian cancers in female carriers. That knowledge of BRCA1/2 PVs helps inform established cancer screening and options for risk reduction.1
“While risks to male carriers of BRCA1/2 PVs are less characterized, there is convincing evidence of increased risk for prostate cancer, pancreatic cancer, and breast cancer in males,” wrote Fred Hutchinson Cancer Center-led researchers. “There has also been a rapid expansion of U.S. Food and Drug Administration-approved targeted cancer therapies, including poly ADP ribose polymerase (PARP) inhibitors, for breast, pancreatic, and prostate cancers associated with BRCA1/2 PVs.”
Researchers from VAMCs in Manhattan, NY; Boston and Philadelphia also participated in the recent narrative review, which summarized the data that led to understanding of cancer risks, targeted cancer therapy options and guidelines for early cancer detection.
The recent report also highlighted areas of emerging research and clinical trial opportunities for male BRCA1/2 PV carriers. “These developments, along with the continued relevance to family cancer risk and reproductive options, have informed changes to guideline recommendations for genetic testing and strengthened the case for increased genetic testing for males,” the authors wrote.
The researchers concluded, “Despite increasing clinical actionability for male carriers of BRCA1/2 PVs, far fewer males than female individuals undergo cancer genetic testing. Oncologists, internists, and primary care clinicians should be vigilant about offering appropriate genetic testing to males. Identifying more male carriers of BRCA1/2 PVs will maximize opportunities for cancer early detection, targeted risk management, and cancer treatment for males, along with facilitating opportunities for risk reduction and prevention in their family members, thereby decreasing the burden of hereditary cancer.”
- Cheng HH, Shevach JW, Castro E, Couch FJ, et. Al. BRCA1, BRCA2, and Associated Cancer Risks and Management for Male Patients: A Review. JAMA Oncol. 2024 Jul 25. doi: 10.1001/jamaoncol.2024.2185. Epub ahead of print. PMID: 39052257.