特定不同领域的gBRCA1和gBRCA2突变影响卵巢癌预后:一项多中心回顾性研究
Yingying Zhu1, Yingying Wang2, Zhen Shen2
1Ovarian Cancer Program, Department of Gynecologic Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
在卵巢癌中发生的生殖线BRCA1C终端域1 (BRCT1) 突变可以改善化疗的预后. BRCA1真正有趣的新基因 (RING) 突变增加了白金耐火性疾病的风险,受益于PARPi治疗.
科学领域:
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
- 基因组医学是基因组医学.
背景情况:
- 在卵巢癌中生殖系BRCA1/2突变 (gBRCA1/2m) 的预后意义受到了争论.
- 在BRCA1/2内部的特定突变领域及其临床影响尚未得到充分研究.
研究的目的:
- 研究不同的gBRCA1/2m域如何影响卵巢癌患者的生存结果.
- 确定与治疗反应和预后相关的特定BRCA1/2突变领域.
主要方法:
- 在313名患有上皮卵巢癌和致病性gBRCA1/2m (2010-2022) 的中国患者中进行了多中心回顾性研究.
- 评估gBRCA1/2m域与无进展生存期 (PFS) 和无区间之间的关联.
- 对治疗结果的分析,包括基于的化疗和多 (ADP-ribose) 聚合酶抑制剂 (PARPi) 维持疗法.
主要成果:
- BRCA1 C-终端域1 (BRCT1) 突变与显著延长的PFS (37.8 vs 22.6 个月) 相关,没有维持治疗.
- BRCA1真正有趣的新基因 (RING) 突变与更短的PFS (13.1 vs. 23.2个月) 和初级抗性疾病风险增加有关 (OR,7.78).
- 在BRCA1 RING突变 (HR,0.10) 和BRCA2 RAD51-绑定域 (RAD51-BD) 突变 (HR,0.29) 的患者中,PARPi维持疗法显示出益处.
结论:
- BRCA1 BRCT1突变预测了化疗改善的预后.
- BRCA1 RING域突变表明白金耐火性疾病的风险更高,需要完全切除瘤.
- 根据突变的位置,PARPi维持疗法的疗效有所不同;BRCA1 RING和BRCA2 RAD51-BD突变显著受益.
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