BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer: A Multicenter Study

Claudia Marchetti, Rossella De Leo, Angela Musella, Marco D'Indinosante, Ettore Capoluongo, Angelo Minucci, Pierluigi Benedetti Panici, Giovanni Scambia, Anna Fagotti

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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.

Original languageEnglish
Pages (from-to)3701-3708
Number of pages8
JournalAnnals of Surgical Oncology
Volume25
Issue number12
DOIs
Publication statusPublished - Nov 2018

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Ovarian Neoplasms
Multicenter Studies
Germ-Line Mutation
Mutation
Recurrence
Survival
Platinum
Biomarkers
Therapeutics

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BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer : A Multicenter Study. / Marchetti, Claudia; De Leo, Rossella; Musella, Angela; D'Indinosante, Marco; Capoluongo, Ettore; Minucci, Angelo; Benedetti Panici, Pierluigi; Scambia, Giovanni; Fagotti, Anna.

In: Annals of Surgical Oncology, Vol. 25, No. 12, 11.2018, p. 3701-3708.

Research output: Contribution to journalArticle

Marchetti, Claudia ; De Leo, Rossella ; Musella, Angela ; D'Indinosante, Marco ; Capoluongo, Ettore ; Minucci, Angelo ; Benedetti Panici, Pierluigi ; Scambia, Giovanni ; Fagotti, Anna. / BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer : A Multicenter Study. In: Annals of Surgical Oncology. 2018 ; Vol. 25, No. 12. pp. 3701-3708.
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title = "BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer: A Multicenter Study",
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.",
author = "Claudia Marchetti and {De Leo}, Rossella and Angela Musella and Marco D'Indinosante and Ettore Capoluongo and Angelo Minucci and {Benedetti Panici}, Pierluigi and Giovanni Scambia and Anna Fagotti",
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TY - JOUR

T1 - BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer

T2 - A Multicenter Study

AU - Marchetti, Claudia

AU - De Leo, Rossella

AU - Musella, Angela

AU - D'Indinosante, Marco

AU - Capoluongo, Ettore

AU - Minucci, Angelo

AU - Benedetti Panici, Pierluigi

AU - Scambia, Giovanni

AU - Fagotti, Anna

PY - 2018/11

Y1 - 2018/11

N2 - 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.

AB - 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.

U2 - 10.1245/s10434-018-6700-6

DO - 10.1245/s10434-018-6700-6

M3 - Article

C2 - 30128899

VL - 25

SP - 3701

EP - 3708

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 12

ER -