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Germline BRCA, chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer.

ABSTRACT: BACKGROUND:To analyze the effects of BRCA1/2 mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). METHODS:We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline BRCA1/2 test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018. Chemotherapy response scores were compared in patients with and without BRCA1/2 mutations. The effects of BRCA1/2 mutations and CRS on survival were evaluated. RESULTS:BRCA1/2 mutations were detected in 47 (28.1%) of the 169 patients. Overall, 16 (34.0%) patients with BRCA1/2 mutations had a CRS 3 to chemotherapy compared to scores of 43 in patients (35.2%) without a mutation. Response scores of 3 in patients with BRCA1/2 mutations were not significantly associated with either improved progression-free survival (PFS) (P?=?0.949) or overall survival (OS) (P?=?0.168). However, CRS 3 in patients without BRCA mutations was significantly associated with both improved PFS (P?=?0.030) and OS (P?=?0.039). In patients with CRS1/2, carriers of BRCA1/2 mutations had better PFS (P?=?0.0344) and OS (P?=?0.043) than wild-type BRCA genotype patients. CONCLUSION:In ovarian cancer patients treated with NAC, CRS did not predict survival for BRCA 1/2 mutation carriers but did for BRCA wild-type patients.

SUBMITTER: Lee YJ

PROVIDER: S-EPMC7057666 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Germline BRCA, chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer.

Lee Yong Jae YJ Kim Hyun-Soo HS Rim John Hoon JH Lee Jung-Yun JY Nam Eun Ji EJ Kim Sang Wun SW Kim Sunghoon S Kim Young Tae YT

BMC cancer 20200304 1

<h4>Background</h4>To analyze the effects of BRCA1/2 mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS).<h4>Methods</h4>We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline BRCA1/2 test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018 ...[more]

PMID: 32131779

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Project description:Study objectiveTo evaluate the effect of surgical approach on overall survival (OS) for women with advanced, epithelial ovarian cancer (EOC) after neoadjuvant chemotherapy (NACT) and determine the sociodemographic and clinical factors associated with surgical approach.DesignThe primary exposure was surgical approach to interval cytoreduction, minimally invasive versus open, and was evaluated by intention to treat. Primary outcome was OS. Associations were examined using Chi-squared tests, Wilcoxon rank sum tests, and multivariate logistic regression. Survival analysis was performed with Kaplan-Meier methods and Cox proportional hazards.SettingThe National Cander Database was used to identify eligible patients.PatientsWomen diagnosed with stage IIIC/IV EOC from 2010-2016.InterventionsPatients were included if they were treated with NACT within 90 days of diagnosis before interval cytoreductive surgery (CRS).Measurements and main resultsA total of 8085 women were identified; 6713 (83%) underwent open interval CRS, and 1372 (17%) underwent minimally invasive interval CRS. The proportion undergoing minimally invasive CRS after NACT increased from 2% in 2010 to 11% in 2016, a nearly 6-fold increase. There was no difference in OS between women who underwent minimally invasive and open interval CRS (median OS 36.5 vs 35.2 months, HR 0.94, 95% CI, 0.86-1.04). After adjusting for demographic and clinical variables, including age, race, ethnicity, income, and Charlson/Deyo score, no difference in OS was observed (HR 0.95, 95% CI, 0.86-1.04). Women of older age (OR 1.35, 95% CI, 1.05-1.74) and Hispanic ethnicity (OR 1.46, 95% CI, 1.14-1.88) had increased odds of receiving minimally invasive CRS after NACT, whereas low income (<$38000/year) women had decreased odds (OR 0.76, 95% CI, 0.60-0.97, p = .03). Length of stay differed for patients undergoing minimally invasive versus open interval CRS (3 vs 5 days, p <.01), but there was no difference in need for postoperative readmission.ConclusionsMinimally invasive CRS has similar survival outcomes to open CRS among women with EOC who have undergone NACT.

Dataset Information

Germline BRCA, chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer.

Publications

Germline BRCA, chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer.

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