Introduction/Background*Brain metastasis (BM) are uncommon among ovarian cancer (OC) patients. Their frequency, risk factors and clinical repercussions are not well described. We assessed OC patients who developed BM, the role of BRCA status and survival implications.

Methodology We retrospectively evaluated 927 consecutive OC patients treated at our center in 2002–2020.

Result(s)*28/927(2.9%) were diagnosed with BM and compared to non-BM cohort. Median age was 60 in both groups, stage III-IV at diagnosis was more common among BM group (96.4% vs. 84.8%, p=0.0065) while platinum sensitivity was similar(92.3% in BM vs. 80.8% in non-BM, p=0.2193). 658 patients tested for BRCA, 33.6%(n=221) were mutation carriers(BRCA+). Of the patients with BM, 13/22 tested were carriers. BRCA+ was significantly higher in the BM group(59.1% vs. 32.9%, p=0.0123). The rate of BM was higher in the BRCA+ compared to BRCA- group(5.8% vs. 2.1%, p=0.0123, HR=3.029; 95%CI: 1.4–6.5). Median time from OC diagnosis to BM and from disease recurrence to BM, was longer for BRCA+ compared to BRCA-(44.3mo vs. 32.3mo and 11.8mo vs. 0.7mo, respectively). Median survival(mOS) was not significantly different in patients with BM or without BM(59.4mo vs. 71.2mo, p=0.36). Following diagnosis of BM, mOS was 20.6mo among BRCA+ and 12.3mo among BRCA(p=0.4266). No correlation was found with PARP inhibitors or bevacizumab treatment.

Conclusion*BM are an infrequent among OC patients. However, the risk is three-folds higher among BRCA+. Interestingly, BM do not significantly alter survival among OC patients; might be related to longer survival in BRCA+ or higher tropism or else.