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Annals of Surgical Oncology

, Volume 25, Issue 12, pp 3701–3708 | Cite as

BRCA Mutation Status to Personalize Management of Recurrent Ovarian Cancer: A Multicenter Study

  • Claudia Marchetti
  • Rossella De Leo
  • Angela Musella
  • Marco D’Indinosante
  • Ettore Capoluongo
  • Angelo Minucci
  • Pierluigi Benedetti Panici
  • Giovanni Scambia
  • Anna Fagotti
Gynecologic Oncology

Abstract

Objective

The aim of this study was to assess the correlation between BRCA mutation status and disease presentation, treatment strategy, and survival in a multicenter series of recurrent high-grade serous ovarian cancer (HGSOC) women.

Methods

A consecutive series of recurrent HGSOC patients with partially or fully platinum-sensitive disease admitted to the Gynecologic Oncology Units of the Catholic University of the Sacred Heart and Sapienza University of Rome. Main eligibility criteria were known BRCA 1/2 germline mutation status and a minimum follow-up period from recurrence of at least 6 months.

Results

Overall, 126 patients met the eligibility criteria, of whom 76 (60%) were BRCA wild-type (BRCAwt) and 50 (40%) were BRCA 1/2 germline mutation carriers (BRCAmut). Among the latter, 37 (74%) patients presented with BRCA1 mutation, and 13 (26%) presented with BRCA2. No differences were found regarding patterns of disease presentation between BRCAwt and BRCAmut women. BRCAmut patients had the best post-recurrence survival (PRS) regardless of having received secondary cytoreductive surgery (SCS) or not, with a 5-year PRS of 73% in non-resected women versus 78% in resected women (p = 0.558). Conversely, BRCAwt patients who underwent complete SCS had a significantly longer PRS compared with BRCAwt patients who did not receive surgery (5-year PRS of 54% vs. 42%; p = 0.048).

Conclusions

Recurrent ovarian cancer BRCAmut patients have the best prognosis regardless of SCS, whereas PRS in BRCAwt women can improve when complete SCS is performed. The identification and incorporation of predictive biomarkers such as BRCA status to tailor the medical and surgical approach is paramount to the success of recurrent HGSOC treatments.

Notes

Acknowledgment

None.

Disclosures

Claudia Marchetti, Rossella De Leo, Angela Musella, Marco D’Indinosante, Ettore Capoluongo, Angelo Minucci, Pierluigi Benedetti Panici, Giovanni Scambia, and Anna Fagotti declare no conflicts of interest.

Supplementary material

10434_2018_6700_MOESM1_ESM.doc (43 kb)
Supplementary material 1 (DOC 43 kb)
10434_2018_6700_MOESM2_ESM.jpg (31 kb)
Supplementary material 2 (JPEG 30 kb)

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Copyright information

© Society of Surgical Oncology 2018
Corrected ​publication ​August/2018

Authors and Affiliations

  • Claudia Marchetti
    • 1
  • Rossella De Leo
    • 2
  • Angela Musella
    • 1
  • Marco D’Indinosante
    • 2
  • Ettore Capoluongo
    • 3
  • Angelo Minucci
    • 3
  • Pierluigi Benedetti Panici
    • 1
  • Giovanni Scambia
    • 2
  • Anna Fagotti
    • 2
  1. 1.Department of Gynecological-Obstetrical Sciences and Urological SciencesSapienza University of RomeRomeItaly
  2. 2.Department of Woman and Child Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCSUniversità Cattolica del Sacro CuoreRomaItalia
  3. 3.Laboratory of Clinical Molecular and Personalized Diagnostics, Fondazione Policlinico Universitario A. Gemelli, IRCCSUniversità Cattolica del Sacro CuoreRomaItalia

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