BRCA2 Mutation Should be Screened Routinely and Early as a Poor Prognostic Biomarker in Prostate Cancer Patients With a Family History of Cancer

Abstract

To focus on clinicopathologic characteristics and prognosis in men with prostate cancer (PCa) with Breast Cancer 2 (BRCA2) mutation and offer some convincing evidence for BRCA2 mutation should be screened early and routinely for patients with family history of cancer, especially when their female relatives have a history of breast and ovarian cancer or male relatives have a history of PCa. We searched relevant articles from PubMed, Embase, Web of Science and the Cochrane Library databases to evaluate the overall survival (OS) and cancer-specific survival (CSS) difference between BRCA2 mutation and non-carriers in patients with prostate cancer. We totally incorporated 525 BRCA2 mutations versus 8,463 non-carriers from 10 studies in our meta-analysis. The results showed that BRCA2 mutation carriers was correlated with worse CSS and OS than non-carriers, with pooled Hazard Ratios (HRs) of 2.53 [95% confidence interval (CI): 2.10-3.06, P<0.001] and 2.21 (95%CI: 1.64-2.99, P<0.001) respectively. The results also demonstrated that BRCA2 mutation carriers also harboring higher Gleason Score (>7), TNM stage (>T3, N1, M1) and risk level than non-carriers. Our meta-analysis showed that BRCA2 mutation predicted poor survival outcomes in patients with PCa especially treatments with radiotherapy. Therefore, BRCA2 mutation as a helpful clinical prognostic factor could stratify the high risk patients and provide clinical strategies for more effective targeted treatments for patients with prostate cancer.