For
breast cancer patients, BRCA gene mutations are predictive of a good response to
chemotherapy, but are hampered by a high risk of bilateral and synchronous or metachronous
ovarian cancer. Novel
therapies such as
PARP-inhibitors have proven effective for BRCA1/2 mutated
ovarian cancer. We present the case of a 50-year-old woman, initially diagnosed with bilateral
luminal B
breast cancer with BRCA1 mutation. She received
neoadjuvant chemotherapy,
modified radical mastectomy and bilateral adnexectomy, while subsequently identifying a synchronous advanced
ovarian cancer, stage FIGO IIIC, followed by adjuvant
platinum chemotherapy and external
radiotherapy. After a 12 months disease-free interval a
brainstem tumor was discovered, for which whole-brain
radiotherapy was performed. She received 6 months of
PARP-inhibitors through an early access program. With only a partial at the end of treatment, the
brainstem tumor was still in progression. Due to evolution of the brain
metastasis, second line
chemotherapy (
taxanes and
Bevacizumab) was administered, with complete radiologic response. The particularity of this case resides in the coexistence of a breast and
ovarian cancer in the same patient with BRCA1-germline mutation who responded to a new line of
therapy - the
PARP inhibitors. While being unable to perform a biopsy, we speculate that the brain
metastasis in this case was most likely of breast origin.