title: [Should knowledge of BRCA1 status impact the choice of chemotherapy in metastatic breast cancer: a review].
abstract: BRCA1 and BRCA2 mutations account for 40% of cancer predisposition gene mutations identified in the current French diagnostic setting. The proteins encoded by these genes are implicated in DNA repair pathways. As a result, loss of BRCA1 or BRCA2 function may modify chemo-sensitivity. This literature review aims to determine whether BRCA1 mutation status should influence the choice of systemic treatment in breast cancer. Fourteen articles and four abstracts from 12 retrospective analyses and 6 prospective studies were identified in the literature review. CMF-type and taxane-based protocols appear to be insufficiently effective, while anthracycline activity does not seem to be affected by BRCA1 status. BRCA1-mutated tumours appear to be highly sensitive to platinum, in both the neoadjuvant and metastatic setting. Olaparib, a PARP inhibitor, has only been evaluated in one study in metastatic patients, with promising results. The presence of a BRCA1 mutation can lead to an adaptation of therapies in the metastatic stages in breast cancer. The rapid identification of BRCA1 mutations and the adaptation of treatment according to this status in the (neo)adjuvant setting is likely to become a reality in the coming years.
authors.affiliation: Institut Bergonié, département d'oncologie médicale, 33076 Bordeaux cedex, France; Institut Bergonié, département de bio-pathologie, laboratoire de génétique moléculaire, unité d'oncogénétique, 33076 Bordeaux cedex, France.
authors.forename: Océane
authors.initials: O
authors.lastname: Clergue
authors.affiliation: Institut Bergonié, département de bio-pathologie, laboratoire de génétique moléculaire, unité d'oncogénétique, 33076 Bordeaux cedex, France.
authors.forename: Natalie
authors.initials: N
authors.lastname: Jones
authors.affiliation: Institut Bergonié, département de bio-pathologie, laboratoire de génétique moléculaire, unité d'oncogénétique, 33076 Bordeaux cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sévenet
authors.affiliation: Institut Bergonié, département d'oncologie médicale, 33076 Bordeaux cedex, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Quenel-Tueux
authors.affiliation: Institut Bergonié, département d'oncologie médicale, 33076 Bordeaux cedex, France. Electronic address: M.Debled@bordeaux.unicancer.fr.
authors.forename: Marc
authors.initials: M
authors.lastname: Debled
mesh_terms: D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D019398:Genes, BRCA1; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage; D009154:Mutation; D010793:Phthalazines / Q000008:administration & dosage; D010879:Piperazines / Q000008:administration & dosage; D011446:Prospective Studies; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D010793:Phthalazines; D010879:Piperazines; D043823:Taxoids; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil; C531550:olaparib; D008727:Methotrexate
keywords: BRCA1; Breast cancer; Cancer du sein; Chemotherapy; Chimiothérapie; Literature review; Metastatic; Métastatique; Neoadjuvant; Néoadjuvant; Revue de la littérature