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BRCA1/2 mutation status is an independent factor of improved survival for advanced (stage III-IV) ovarian cancer
Vilius Rudaitis1, Tadas Zvirblis, Daiva Kanopiene
1*Clinics of Internal, Family Medicine, and Oncology, Faculty of Medicine, Vilnius University; †Department of Gynecology, Centre of Obstetrics and Gynecology, and ‡Hematology, Oncology, and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos; §Vilnius University Institute of Oncology; ∥Department of Molecular and Regenerative Medicine, Hematology, Oncology; and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Klinikos; and ¶State Research Institute, Innovative Medicine Center, Vilnius, Lithuania.
Objective:
The aim of this study was to explore BRCA mutation frequency and to evaluate its impact on prognosis of advanced-stage ovarian cancer patients treated with debulking surgery and platinum-based chemotherapy.
Methods:
Patients with advanced-stage epithelial ovarian cancer were enrolled in a prospective, single-center study from September 2008 to December 2011. All cases were screened for BRCA1 and BRCA2 gene mutations. Progression-free survival (PFS) was assessed between BRCA1/2 mutation carriers and BRCA1/2 wild-type patients.
Results:
One hundred seven patients were enrolled and screened for BRCA1 and BRCA2 mutations; 51.4% patients were positive for BRCA1/2 gene mutation, 63.6% of which carried a single Baltic mutation, and 98.2% of them had serous histology. Older age (hazard ratio [HR], 1.032; 95% confidence interval [CI], 1.010-1.055; P = 0.0047), nonoptimal cytoreduction (HR, 3.170; 95% CI, 1.986-5.060; P < 0.0001), and BRCA1/2 wild type (HR, 1.625 [1.003-2.632]; P = 0.0486) were significantly associated with shorter PFS in multivariate Cox regression analysis. Only the nonoptimal cytoreduction was a statistically significant risk factor for shorter overall survival (HR, 2.684; 95% CI, 1.264-5.701; P= 0.0102).
Conclusions:
Advanced ovarian cancer patients harboring BRCA1/2 mutation treated with debulking surgery and platinum-based adjuvant chemotherapy have a longer PFS.
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