Claudia Marchetti1, Rossella De Leo2, Angela Musella1, Marco D'Indinosante2, Ettore Capoluongo3, Angelo Minucci3, Pierluigi Benedetti Panici1, Giovanni Scambia2, Anna Fagotti4. 1. Department of Gynecological-Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome, Italy. 2. Department of Woman and Child Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia. 3. Laboratory of Clinical Molecular and Personalized Diagnostics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia. 4. Department of Woman and Child Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia. annafagotti@libero.it.
Abstract
OBJECTIVE: The aim of this study was to assess the correlation between BRCA mutation status and disease presentation, treatment strategy, and survival in a multicenter series of recurrent high-grade serous ovarian cancer (HGSOC) women. METHODS: A consecutive series of recurrent HGSOC patients with partially or fully platinum-sensitive disease admitted to the Gynecologic Oncology Units of the Catholic University of the Sacred Heart and Sapienza University of Rome. Main eligibility criteria were known BRCA 1/2 germline mutation status and a minimum follow-up period from recurrence of at least 6 months. RESULTS: Overall, 126 patients met the eligibility criteria, of whom 76 (60%) were BRCA wild-type (BRCAwt) and 50 (40%) were BRCA 1/2 germline mutation carriers (BRCAmut). Among the latter, 37 (74%) patients presented with BRCA1 mutation, and 13 (26%) presented with BRCA2. No differences were found regarding patterns of disease presentation between BRCAwt and BRCAmut women. BRCAmut patients had the best post-recurrence survival (PRS) regardless of having received secondary cytoreductive surgery (SCS) or not, with a 5-year PRS of 73% in non-resected women versus 78% in resected women (p = 0.558). Conversely, BRCAwt patients who underwent complete SCS had a significantly longer PRS compared with BRCAwt patients who did not receive surgery (5-year PRS of 54% vs. 42%; p = 0.048). CONCLUSIONS: Recurrent ovarian cancer BRCAmut patients have the best prognosis regardless of SCS, whereas PRS in BRCAwt women can improve when complete SCS is performed. The identification and incorporation of predictive biomarkers such as BRCA status to tailor the medical and surgical approach is paramount to the success of recurrent HGSOC treatments.
OBJECTIVE: The aim of this study was to assess the correlation between BRCA mutation status and disease presentation, treatment strategy, and survival in a multicenter series of recurrent high-grade serous ovarian cancer (HGSOC) women. METHODS: A consecutive series of recurrent HGSOC patients with partially or fully platinum-sensitive disease admitted to the Gynecologic Oncology Units of the Catholic University of the Sacred Heart and Sapienza University of Rome. Main eligibility criteria were known BRCA 1/2 germline mutation status and a minimum follow-up period from recurrence of at least 6 months. RESULTS: Overall, 126 patients met the eligibility criteria, of whom 76 (60%) were BRCA wild-type (BRCAwt) and 50 (40%) were BRCA 1/2 germline mutation carriers (BRCAmut). Among the latter, 37 (74%) patients presented with BRCA1 mutation, and 13 (26%) presented with BRCA2. No differences were found regarding patterns of disease presentation between BRCAwt and BRCAmut women. BRCAmut patients had the best post-recurrence survival (PRS) regardless of having received secondary cytoreductive surgery (SCS) or not, with a 5-year PRS of 73% in non-resected women versus 78% in resected women (p = 0.558). Conversely, BRCAwt patients who underwent complete SCS had a significantly longer PRS compared with BRCAwt patients who did not receive surgery (5-year PRS of 54% vs. 42%; p = 0.048). CONCLUSIONS: Recurrent ovarian cancer BRCAmut patients have the best prognosis regardless of SCS, whereas PRS in BRCAwt women can improve when complete SCS is performed. The identification and incorporation of predictive biomarkers such as BRCA status to tailor the medical and surgical approach is paramount to the success of recurrent HGSOC treatments.
Authors: Vito Andrea Capozzi; Andrea Rosati; Luigi Carlo Turco; Giulio Sozzi; Matteo Riccò; Benito Chiofalo; Giuseppe Vizzielli Journal: Gland Surg Date: 2020-08
Authors: Felipe Leonardo Estati; Rafaela Pirolli; Viviane Teixeira Loiola de Alencar; Adriana Regina Gonçalves Ribeiro; Maria Nirvana Formiga; Giovana Tardin Torrezan; Dirce Maria Carraro; Andrea Paiva Gadelha Guimarães; Glauco Baiocchi; Alexandre André Balieiro Anastácio da Costa Journal: Ann Surg Oncol Date: 2020-11-21 Impact factor: 5.344