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Brain metastasis in epithelial ovarian cancer by BRCA1/2 mutation status.

Abstract：

OBJECTIVE:To evaluate clinical outcomes of patients with BRCA-associated ovarian cancer who developed brain metastases (BM). METHODS:Patients with epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) and BM, treated at a single institution from 1/1/2008-7/1/2018, were identified from two institutional databases. Charts and medical records were retrospectively reviewed for clinical characteristics and germline BRCA mutation status. Appropriate statistics were used. RESULTS:Of 3649 patients with EOC, 91 had BM (2.5%). Germline mutation status was available for 63 (69%) cases; 21 (35%) of these harbored a BRCA1/2 mutation (15 BRCA1, 6 BRCA2). Clinical characteristics were similar between groups. BM were diagnosed at a median of 31 months (95% CI, 22.6-39.4) in BRCA-mutated (mBRCA) and 32 months (95% CI, 23.7-40.3) in wild-type BRCA (wtBRCA) (p = 0.78) patients. Brain metastases were the only evidence of disease at time of BM diagnoses in 48% (n = 10) mBRCA and 19% (n = 8) wtBRCA (p = 0.02) patients. There was no difference in treatment of BM by mutation status (p = 0.84). Survival from time of BM diagnosis was 29 months (95%CI, 15.5-42.5) in mBRCA and 9 months (95% CI, 5.5-12.5) in wtBRCA patients, with an adjusted hazard ratio (HR) of 0.53, p = 0.09; 95% CI, 0.25-1.11. HR was adjusted for presence of systemic disease at time of BM diagnosis. CONCLUSION:This is the largest study to date comparing outcomes in patients with EOC and BM by mutation status. mBRCA patients were more likely to have isolated BM, which may be a factor in their long survival. This supports the pursuit of aggressive treatment for mBRCA EOC patients with BM. Additional studies examining the correlation of BRCA mutational status with BM are warranted.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Stasenko M,Cybulska P,Feit N,Makker V,Konner J,O'Cearbhaill RE,Alektiar KM,Beal K,Gardner GJ,Long Roche KC,Sonoda Y,Chi DS,Zivanovic O,Leitao MM Jr,Cadoo KA,Tew WP

doi

10.1016/j.ygyno.2019.05.004

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

144-149

issue

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(19)31229-6

journal_volume

154

pub_type

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Brain metastasis in epithelial ovarian cancer by BRCA1/2 mutation status.