Purpose
To evaluate if single-nucleotide polymorphisms (SNPs) reflecting common variation in the tumor suppressor BRCA1 affects prostate cancer (CaP) outcomes. Because radiation therapy (RT) induces DNA damage, we hypothesized that common variation in BRCA1 plays a role in progression to lethal CaP, particularly in patients receiving RT.
Methods
We followed 802 men diagnosed with localized CaP (cT1-T3/N0/M0) who were treated with RT in the US Health Professionals Follow-up Study (HPFS) and Physicians’ Health Study (PHS), for progression to lethal CaP. Six single-nucleotide polymorphisms (rs3737559, rs1799950, rs799923, rs915945, rs4474733, and rs8176305) were genotyped in HPFS to capture common variation across BRCA1. rs4474733 and rs8176305 were also evaluated in the PHS cohort. Cox proportional hazards models were used to estimate per-allele hazard ratios (HR) and 95% confidence intervals (CI) stratified by primary treatment.
Results
In the RT group (n=802) 71 men progressed to lethal disease during a mean follow-up of 12 years. We found that two SNPs, rs4473733 (HR: 0.65; 95%CI 0.42-0.99) and rs8176305 (HR: 2.03; 95%CI 1.33-3.10), were associated with lethal CaP in men receiving RT.
Conclusions
Common variation in BRCA1 may influence clinical outcomes in patients receiving RT for localized CaP by modifying the response to RT. Our findings merit further follow-up studies to validate these SNPs and better understand their functional and biological significance.