Article Text

Download PDFPDF
EP875 Novel clinical roles for BRCA1/2 germ-line status: 1) primary surgery is superior to neoadjuvant chemotherapy in sporadic but not in hereditary ovarian cancers; 2) Favorable anatomic pattern of relapses in BRCA1/2 mutation carriers
  1. E Imyanitov,
  2. T Gorodnova,
  3. A Sokolenko,
  4. V Ni,
  5. A Ivantsov,
  6. K Kotiv,
  7. S Petrik,
  8. I Amelina and
  9. I Berlev
  1. N.N. Petrov Institute of Oncology, St. Petersburg, Russian Federation


Introduction/Background BRCA1/2-driven ovarian cancers (OCs) compose a distinct group of OC, which is characterized by high sensitivity to platinum-based therapy. This study aimed to compare the disease outcomes in BRCA1/2 mutation carriers vs. non-carriers.

Methodology The analysis included 283 consecutive OC patients, who underwent optimal cytoreduction (size of residual tumor <1 cm (n=156) or complete tumor excision (n=127)) upon primary debulking surgery (PDS) (n=168) or after neoadjuvant chemotherapy (NACT) (n=115). 84 patients carried germ-line mutation in BRCA1 (n=78) or BRCA2 (n=6) genes, while 199 OCs were classified as sporadic cases.

Results Patients treated with NACT demonstrated inferior median disease-free interval (DFI) compared to women subjected to PDS followed by adjuvant therapy (7.9 months vs. 19.5 months, P<0.001). Interestingly, this difference remained clinically meaningful and statistically significant only for sporadic OC (5.1 months vs. 20.7 months, P<0.001), while BRCA1/2-driven carcinomas showed relatively similar DFI irrespectively of the sequence of the treatments (13.1 months vs. 16.7 months, P=0.11). The disease relapse was observed in 72/84 (86%) BRCA1/2-mutated patients and 165/199 (83%) women with sporadic cancer. 35/72 (49%) BRCA1/2-associated OCs relapsed by a single tumor lump, which was potentially amenable for radiological or surgical ablation; this estimate was significantly lower in sporadic cancer patients (52/165 (32%); P=0.01).

Conclusion BRCA1/2 status may contribute to the choice between PDS and NACT, therefore the turnaround time for BRCA1/2 testing may be important for proper treatment planning. BRCA1/2-driven OCs have more favorable pattern of relapses as compared to sporadic cases.

Disclosure This work has been supported by the Russian Science Foundation, grant 19-15-00168.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.