Understanding PARP Inhibitors - The Revolutionary Ovarian Cancer Medicine Bianca Balti Qualifies For
- Sports Illustrated swimsuit model Bianca Balti, who carries the BRCA1 gene mutation, was recently diagnosed with stage 3C ovarian cancer. As she preps for chemotherapy, and although it’s unclear what medicine she will be taking, we’re reminded of the revolutionary ovarian cancer medicine that she qualifies for.
- Ovarian cancer has been called the “cancer that whispers,” because women often don’t experience symptoms until their cancer has already reached its late stages.
- PARP inhibitors are available to almost all women, though women with BRCA gene mutations or who are HRD proficient may benefit the most from these drugs.
- American Society of Clinical Oncology (ASCO) guidelines recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy. There are some significant side effects to consider, and thus, the decision to take PARP inhibitors should be made in consultation with your individual oncologist.
- SurvivorNet offers a comprehensive guide to ovarian cancer features advice from some of the nation’s top gynecologic oncologists, to guide you through every stage of the diagnosis and treatment process. Check out SN Local, featuring 20 cities across the U.S., to explore expertise and community near you.
Sports Illustrated swimsuit model Bianca Balti, a 40-year-old mom of two, was recently diagnosed with stage 3C ovarian cancer, just two years after learning she carried the BRCA1 gene mutation and underwent a preventative double mastectomy. Now, after undergoing emergency surgery and preparing for chemotherapy, the Italian native, who qualifies for a category of revolutionary drugs in ovarian cancer treatment, known as PARP inhibitors, is embracing "life's hurdles" with optimism. Although it's unclear what type of medicine Balti will be given during her treatment, it's important to understand that she's eligible for PARP inhibitors. This class of medicine is most effective in women with a BRCA gene mutations or those who have a molecular factor called HRD proficiency. However, the
American Society of Clinical Oncology (ASCO) guidelines
recommend PARP inhibitors be offered to women, with or without genetic mutations, who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy.
What You Need to Know About BRCA1 Gene Mutations Balti announced her diagnosis on social media this week, sharing a variety of photos of her in the hospital, saying, "Last Sunday, I checked myself into the ER to find out that my lower abdominal pain was stage 3C ovarian cancer. "It’s been a week full of fear, pain and tears but mostly love, hope, laughter, and strength. (check these pics out for proof, lol)."
RELATED: How Serious is My Illness? ‘Staging’ Ovarian Cancer She continued, "I have a long journey ahead, but I know I will beat this. For myself, my loved ones (my daughters are at the top of the list), and all of you who need strength, you can borrow some of mine cause I have loads. "Life happens; give it a reason. So far, cancer has given me a chance to find beauty through life’s hurdles." Leading up to her ovarian cancer diagnosis the fashion model learned she had an increased risk of getting breast cancer a few years ago, and chose undergo a preventative double mastectomy [surgical removal of both breasts] to minimize that risk. She has since been hoping that her story can raise awareness for BRCA1 gene mutations, and empower others to get their genes checked and annual mammograms.
RELATED: Where Can I Get Genetic Testing? Balti discovered she had an inherited
BRCA1 gene mutation back in 2022, after deciding to get a saliva gene test as she neared the age one of her paternal aunts had passed away from aggressive breast cancer, she revealed in an interview with
Vogue, earlier this year. Recounting what led her to get the gene test, the 5-foot-9 fashion model admitted, " wasn’t sick, yet … but I knew the chances were much higher that I would be one day. And I now had the free will to do something about it." Balti, who also underwent preventative double mastectomy on December 8, 2022, wanted to reduce her chances of getting cancer, adding, "I wanted to be a good role model for my daughters and take care of my health. The hardest part of this entire process has been the fear. Of finding out the diagnosis, the unknown, of taking time off work, of not knowing how my body will look.”
Understanding BRCA1 Gene Mutations
Our genes are made up of DNA, a long sequence of chemical building blocks (nucleotides) that determine our traits. The sequence of nucleotides in a gene guides cells to assemble a specific protein with a specific function. Sometimes, a change or error occurs in the DNA sequence, resulting in a gene mutation. Such mutations may cause a protein to malfunction or not be produced at all.
RELATED: Major Advance: PARP Inhibitor Pill Extends Life For Women With High Risk Breast Cancer & BRCA Mutations How Genetic Testing Helps Cancer Patients
In the case of the BRCA1 gene, mutations can prevent the production of its protein or render it ineffective in repairing damaged DNA. This could lead to additional genetic alterations that may increase the risk of developing specific types of cancer. The most common cancers associated with BRCA1 mutations are breast cancer and
ovarian cancer , although it can also increase the risk of other cancers, such as prostate cancer and pancreatic cancer.
- Germline mutations: These are inherited mutations present in every cell of the body. If one parent carries a BRCA1 mutation, there is a 50% chance that their child will inherit it. Germline mutations in the BRCA1 gene largely contribute to hereditary breast and ovarian cancer syndromes.
- Somatic mutations: These occur during a person's lifetime and only affect some cells. Somatic mutations in the BRCA1 gene are not inherited, but they may contribute to the development of sporadic cancers (non-hereditary).
It is crucial to note that not all BRCA1 gene mutations will lead to cancer. The presence of a mutation merely signifies an increased risk compared to those without the mutation. Other factors, such as lifestyle, environment, and additional genetic factors, can also contribute to cancer development. Understanding the BRCA1 gene mutation is the first step in grasping the risks and potential consequences it imposes on an individual's health. In the case of ovarian cancer: The lifetime risk of developing ovarian cancer for women with a BRCA1 mutation is around 39%, compared to a general risk of less than 2%. With ovarian cancer often being diagnosed at an advanced stage, this increased risk is an important consideration for women carrying the BRCA1 mutation.
What Is a BRCA Mutation? PARP Inhibitors For Ovarian Cancer
PARP inhibitors have exploded onto the scene of ovarian cancer treatment — and
research is showing that more women may be eligible to receive them. This type of medicine is available to almost all women, though women with BRCA gene mutations or who are HRD proficient may benefit the most from these drugs. However, the American Society of Clinical Oncology (ASCO)
guidelines recommend PARP inhibitors be offered to women,
with or without genetic mutations , who are newly diagnosed with stage III or IV ovarian cancer and have improved with chemotherapy. This class of drug has very recently been shown to provide benefit for patients with ovarian cancer as part of an initial plan of treatment. PARP inhibitors are primarily still used in women whose disease has come back, or as part of an ongoing course of treatment called maintenance therapy. In maintenance therapy, women whose ovarian cancer has recurred take PARP inhibitors following 4-6 cycles of platinum-based chemotherapy. The goal: keep the cancer in remission for as long as possible.
Hard-To-Treat Ovarian Cancer Now Has Some Promising Treatment Options PARP inhibitors are best used in women as maintenance therapy if they've responded well to platinum-based chemotherapy. These types of patients are known as 'platinum-sensitive', meaning they responded well to a chemotherapy that uses platinum as its base.
You May Be Eligible for a PARP Inhibitor How to Decide? One of the key things to know about PARP inhibitors is that your genetic makeup and specific features of your cancer will have a significant impact on how effective these drugs may be. Experts tell SurvivorNet that every woman with ovarian cancer should get a genetic test to determine if they have a mutation called BRCA, because the mutation enables PARP inhibitors to function much more powerfully. As of now, women with BRCA mutations can receive PARP inhibitors earlier on in the course of their treatment as one of the first steps (after their cancer has responded to platinum-based chemotherapy). Women with BRCA mutations respond best to PARP inhibitors. But why? Tumor cells with BRCA mutations have problems repairing DNA already, and the PARP inhibitors make that worse, causing cancer cells to die. Nonetheless, women without BRCA mutations at all have still shown more benefit as compared to observation or 'watchful waiting.’ Importantly, there is increasing data that even women without BRCA mutations can still derive some benefit from these drugs. Again, it’s really important to know that many doctors are still getting comfortable with PARP inhibitors, and because the research is developing so quickly, your genetic makeup and the stage of your cancer may well make you a potential candidate. Ultimately, while PARP inhibitors can be beneficial for many women with ovarian cancer, it doesn't necessarily mean everyone should take them. There are some significant
side effects to consider, and thus, the decision to take PARP inhibitors should be made in consultation with your individual oncologist.
All About Ovarian Cancer
Ovarian cancer has been called the “cancer that whispers” because women often don’t experience symptoms until their cancer has already reached its late stages. The symptoms that do appear at first are hard to identify as cancer. “Ovarian cancer does not have any specific symptoms,”
Dr. Beth Karlan , a gynecologic oncologist at UCLA Medical Center, told SurvivorNet. The symptoms of ovarian cancer may include the following, according to SurvivorNet experts.
- A feeling of bloating or fullness
- Pain in the pelvis or abdomen
- Nausea
- Vomiting
- Changes in bowel habits
WATCH: Treating ovarian cancer. Meanwhile, a
hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix, according to the National Cancer Institute. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy. The standard of care for ovarian cancer patients is chemotherapy, which helps many patients reach remission. Ovarian cancer recurrence happens in “almost 25 percent of cases with early-stage diseases and in more than 80 percent with more advanced stages,” according to research published in
Gland Surgery medical journal. With recurrence a strong possibility for this disease, especially in the later stages of ovarian cancer, certain drug treatments to deal with it are giving many women hope. Maintenance therapy is continued treatment after the patient finishes their initial treatment. After an ovarian cancer patient completes a round of treatments — such as surgery and chemotherapy — her doctor may recommend some form of maintenance therapy to try and delay possible recurrence. Maintenance therapy can involve taking an oral pill called a PARP inhibitor every day after chemotherapy and can keep cancer in remission longer.
Genetic testing helps doctors determine the best maintenance therapy.
WATCH: How your ovarian cancer responds to certain types of chemotherapies guides your future treatments. Contributing: SurvivorNet Staff 
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