Melphalan as a treatment for BRCA-related ovarian carcinoma: can you teach an old drug new tricks?

Abstract:

:Late-stage ovarian carcinoma is almost universally fatal. BRCA mutations are associated with an improved outcome and enhanced sensitivity to platinum chemotherapy, yet recurrence and platinum resistance remain a major problem and highly effective regimens following platinum failure do not yet exist. Here we report a remarkable case of cure following platinum-resistant stage III ovarian carcinoma in a woman with a BRCA2 mutation. The patient was subsequently treated with oral melphalan therapy and has not recurred in over 25 years. Melphalan is a bifunctional alkylator that creates inter- and intra-strand DNA cross-links. In a pharmaceutical screen, melphalan was shown to be selectively toxic to BRCA2-deficient breast cancer cell lines and produced a longer relapse-free survival in mice than did cisplatin or olaparib. There is increasing evidence to consider BRCA mutation status when selecting chemotherapy regimens, and melphalan treatment for BRCA-related ovarian cancer merits further investigation. Focusing attention on long-term survivors may provide new mechanistic insights into the biology of chemo-responsiveness.

journal_name

J Clin Pathol

authors

Osher DJ,Kushner YB,Arseneau J,Foulkes WD

doi

10.1136/jcp.2010.086405

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

924-6

issue

10

eissn

0021-9746

issn

1472-4146

pii

jcp.2010.086405

journal_volume

64

pub_type

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