Cancer Res Treat.  2023 Jan;55(1):245-257. 10.4143/crt.2022.232.

Effect of BRCA1/2 Mutational Status on Survival Outcomes According to Secondary Cytoreductive Surgery and Maintenance Therapy in Platinum-Sensitive Relapsed Ovarian Cancer: A Real-World Evidence Study

• Kim SI
• Lim H
• Kim HS
• Chung HH
• Kim JW
• Park NH
• Song YS
• Lee M

• KMID: 2538008
• DOI: http://doi.org/10.4143/crt.2022.232

Abstract

Purpose
This study aimed to investigate the impact of BRCA1/2 mutational status on survival outcomes in patients with platinum-sensitive relapsed (PSR) epithelial ovarian cancer (EOC).
Materials and Methods
We retrospectively identified patients who received secondary treatment for PSR EOC at our institution between January 2007 and June 2021 and who underwent BRCA1/2 gene testing by either germline or somatic methods. The association between BRCA1/2 mutational status and survival outcomes was evaluated. Both secondary cytoreductive surgery (CRS) and maintenance therapy were stratified considering real-world clinical practice.
Results
Of 262 patients, 91 (34.7%) and 171 (65.3%) were assigned to BRCA1/2 mutation and wild-type groups, respectively. The two groups had similar proportions of patients undergoing secondary CRS (26.4% vs. 32.7%, p=0.286) and maintenance therapy (54.9% vs. 46.2%, p=0.178). Overall, no differences in progression-free survival (PFS; median, 19.7 vs. 15.1 months, p=0.120) and overall survival (OS; p=0.400) were observed between the two groups. In multivariate analyses, BRCA1/2 mutational status was not associated with PFS (adjusted hazard ratio, 0.816; 95% confidence interval, 0.596 to 1.119; p=0.207). BRCA1/2 mutational status did not affect PFS among patients who underwent secondary CRS (n=80) and among those who did not (n=182) (p=0.074 and p=0.222, respectively). PFS did not differ in the BRCA1/2 mutational status among the patients who received bevacizumab maintenance (n=90, p=0.992).
Conclusion
In this real-world evidence study, BRCA1/2 mutational status itself was not associated with PFS and OS in PSR EOC, which was consistent with whether secondary CRS or not and with bevacizumab maintenance.

Keyword

Ovarian neoplasms; Epithelial ovarian carcinoma; Surgery; Maintenance therapy; Prognosis; Survival

Figure

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  Fig. 1 Comparisons of survival outcomes according to the BRCA1/2 mutational status: (A, C) progression-free survival, (B, D) overall survival. CI, confidence interval.

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  Fig. 2 Comparisons of progression-free survival based on secondary cytoreductive surgery. (A) All patients. (B) BRCA mutation group. (C) BRCA wild-type group. (D) Combinations of secondary cytoreductive surgery and BRCA1/2 mutational status. CI, confidence interval; CRS, cytoreductive surgery.

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  Fig. 3 Comparisons of progression-free survival according to the maintenance therapy by BRCA1/2 mutational status (A, B) and by secondary cytoreductive surgery (CRS) (C, D). BEV, bevacizumab; CI, confidence interval; PARPi, poly(ADP-ribose) polymerase inhibitor.

Reference

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