The presence of germline or somatic BRCA1/2 mutation (gBRCA1/2 or sBRCA1/2) on epithelial ovarian cancer (EOC) patients (pts) improves progression-free survival (PFS) and overall survival (OS). BRCAm is the only validated molecular biomarker both prognostic and predictive of platinum and PARPi response. Identification of these pts is already mandatory to optimize treatment strategies and the need for genetic counselling. We aimed to describe our BRCAm EOC population to analyse tumor response and survival outcomes.
This was an observational, retrospective study with 194 pts diagnosed with advanced EOC (FIGO stage III-IV) in our institution from 01/2015 to 01/2021. The presence of BRCA1/2 mutation was determined using next generation sequencing (NGS).
The most common histology was high-grade serous carcinoma in 86’6%. Median age was 59 years (25-87). BRCA status was WT/mut/unk: 71’1%/19’1%/9’8% (17/37 BRCA1, 20/37 BRCA2). On BRCAm population, 40’5% pts had a family history of EOC or breast cancer (BC) (2/35 pts had a previous BC, 100% BRCA1m). 37’8% had a primary debulking surgery (PDS) (8/13 R0) and 40’5% had an interval debulking surgery (IDS) (14/15 R0). Median OS in pts with PDS was 64 months (mo) (43 mo on WT population) vs 30 mo in pts who were not candidates for surgery (7/37 pts with FIGO stage IV; 13 mo on WT population) (p<0.04). Carboplatin/paclitaxel was the most frequently prescribed CT (70’3%, 10/26 pts neoadjuvant) as first line followed by PARPi in 8 pts (pts newly diagnosed). 15/37 pts progressed to first line (0/15 pts treated with PARPi) and 73% showed a platinum-sensitive disease (9/11 received maintenance PARPi, 3/9 of them relapsed after 12 mo of treatment). First-line PFS was 19 mo. The median follow up was 26 mo. 5/37 pts died due to clinical impairment or relapsed.
Early identification of BRCAm EOC pts is essential in order to optimize treatment sequence, and identify women who can receive PARPi therapy which is established as the standard of care for this population.
The authors.
Has not received any funding.
P. Estévez García: Financial Interests, Personal, Invited Speaker: PharmaMar; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: GSK; Financial Interests, Personal, Invited Speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Personal, Invited Speaker: Clovis; Financial Interests, Personal, Advisory Board: PharmaMar; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: GSK; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Personal, Advisory Board: Clovis. All other authors have declared no conflicts of interest.