The role of BRCA1 and BRCA2 in prostate cancer

open access

Conclusion

Germline mutations in the BRCA genes, mainly in BRCA2, not only increase the risk of developing PCa, but also have implications in the prognosis and management of the disease. BRCA-related PCa is usually aggressive, and radical treatments are preferred to surveillance, even for low-risk cases. Further studies are needed to design a tailored management for these patients. An ongoing study, IMPACT, will clarify the benefits of PCa screening in this higher-risk population. Promising clinical trials are evaluating the role of PARP inhibitors in the metastatic setting, but more studies are needed to establish the role of adjuvant treatment, with PARP inhibitors and/or conventional chemotherapy. The role of chemoprophylaxis in patients with high risk of aggressive forms of PCa also needs to be addressed. A better characterization of BRCA-related prostate tumours would help to identify sporadic cases with potential lethal forms of the disease that might benefit from the therapeutic strategies designed for BRCA-mutated tumours.