An abstract that appeared at ASCO 2019 that indicated that men with either the germline DNA repair gene BRCA2 or a CHEK2 mutation became castrate resistant more quickly than men without these mutations.

The study evaluated the impact of these gene mutations on the time it took men to develop castration resistance in men with metastatic hormone-naïve (not yet having started ADT) prostate cancer.

The study included 76 men with hormone-naïve metastatic prostate cancer who went on to received first-line ADT by LHRH analog between 2014 and 2017.

Of these men, 19% had germline mutations (mutations in the DNA that they were born with) in their BRCA2 and CHEK2 genes. These men had a significantly shorter median time to developing castration resistance compared to men who did not have these mutations (7.9 vs. 48.7 months).

The study showed that having the BRCA2 and CHEK2 mutations are independent prognostic factors for time to developing castration resistance, especially in men with low-volume metastatic prostate cancer spread.

In summary, these results demonstrate worse outcomes in men with germline BRCA2 and CHEK2 mutations compared with men without these mutations when treated with standard first-line ADT with LHRH analogs.

VB Matveev, L Lyubchenko, A Kirichek

http://abstracts.asco.org/239/AbstView_239_270177.html