Clinical Characteristics of Ovarian Cancer Relapse in BRCA1/2 Germ-Line Mutation Carriers and Noncarriers

Conference Correspondent - ESMO 2018


Germ-line mutations in BRCA1 or BRCA2 genes are implicated in approximately 15% of ovarian cancers.1 Although this subset of ovarian cancers is generally characterized by a good initial response to chemotherapy, 10-year survival is not different between those with BRCA1/2 mutations and noncarriers.2 In a retrospective analysis of 212 women with relapsed high-grade serous ovarian cancer between 2000 and 2014, Sokolenko and colleagues sought to further evaluate the distinguishing clinical features between hereditary and sporadic ovarian cancer.3

Of the included patients, 113 (53.3%) and 99 (46.7%) underwent complete primary or interval surgical debulking, respectively. Most women (n = 146; 68.9%) were negative for BRCA1/2 germ-line mutations, whereas 66 (31.1%) were carriers of BRCA1/2 mutations. As the investigators expected, the median platinum-free interval (PFI) in BRCA1/2 carriers was longer compared with sporadic cases (13.2 months vs 8.0 months; P <.001). Furthermore, the proportion of ovarian cancer cases with PFI >12 months was significantly higher among BRCA1/2 carriers (38/66 [58%]) compared with patients with sporadic disease (51/146 [35%]; P = .003).

Looking at relapse location, no statistical between-group difference was observed in the frequency of relapses to distant locations (P = .4). However, systemic recurrences (ie, multiple lesions) occurred significantly more frequently in sporadic cases (98/144 [68%]) compared with carriers of BRCA1/2 mutations (30/60 [50%]; P = .02) and were associated with a shorter PFI (P = .003). In addition, a greater proportion of BRCA1/2 mutation carriers than noncarriers could be subjected to local treatment (locoregional discrete recurrence with lymphatic/transcoelomic spread) (29/66 [44%] vs 45/146 [31%], respectively; P = .045).

Taken together, the results of this study indicate that ovarian cancers driven by BRCA1/2 are characterized by a more favorable mode of relapse than sporadic high-grade serous ovarian cancers.


References

  1. Pan Z, et al. Oncotarget. 2017;8(57):97657-97670.
  2. Huang YW. Medicine. 2018;97:2(e9380).
  3. Sokolenko AP, et al. ESMO 2018. Abstract 991P.