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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2022.232    [Accepted]
Effect of BRCA1/2 Mutational Status on Survival Outcomes According to Secondary Cytoreductive Surgery and Maintenance Therapy in Platinum-Sensitive Relapsed Ovarian Cancer: A Real-World Evidence Study
Se Ik Kim1 , Hyunji Lim1, Hee Seung Kim1, Hyun Hoon Chung1, Jae-Weon Kim1, Noh Hyun Park1, Yong-Sang Song1, Maria Lee1,2
1Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
2Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
Correspondence  Maria Lee ,Tel: 82-2-2072-2842, Fax: 82-2-762-3599 , Email: marialeemd@gmail.com
Received: April 12, 2022;  Accepted: July 15, 2022.  Published online: July 19, 2022.
ABSTRACT
Purpose
To investigate the impact of BRCA1/2 mutational status on survival outcomes in patients with platinum-sensitive relapsed (PSR) epithelial ovarian cancer (EOC).
Materials and Methods
We retrospectively identified patients who received secondary treatment for PSR EOC at our institution between January 2007 and June 2021 and who underwent BRCA1/2 gene testing by either germline or somatic methods. The association between BRCA1/2 mutational status and survival outcomes was evaluated. Both secondary CRS and maintenance therapy were stratified considering real-world clinical practice.
Results
Of 262 patients, 91 (34.7%) and 171 (65.3%) were assigned to BRCA1/2 mutation and wild-type groups, respectively. The two groups had similar proportions of patients undergoing secondary cytoreductive surgery (CRS) (26.4% vs. 32.7%; p=0.286) and maintenance therapy (54.9% vs. 46.2%; p=0.178). Overall, no differences in progression-free survival (PFS; median, 19.7 vs. 15.1 months; p=0.120) and overall survival (OS, p=0.400) were observed between the two groups. In multivariate analyses, BRCA1/2 mutational status was not associated with PFS (adjusted HR, 0.816; 95% CI, 0.596-1.119; p=0.207). BRCA1/2 mutational status did not affect PFS upon comparing patients who underwent secondary CRS (n=80) and those who did not (n=182) (p=0.074 and p=0.222, respectively). PFS did not differ in the BRCA1/2 mutational status among the patients who received bevacizumab maintenance (n=90; p=0.992).
Conclusion
In this real-world evidence study, BRCA1/2 mutational status itself was not associated with PFS and OS in PSR EOC, which was consistent with whether secondary CRS or not and with bevacizumab maintenance.
Key words: Ovarian neoplasms, Epithelial ovarian cancer, BRCA1, BRCA2, Surgery, Maintenance therapy, Prognosis, Survival
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