Approximately 15% of ovarian cancer (OC) incidence is attributed to germ-line mutations in BRCA1 or BRCA2 genes. Being a distinct biological subset of OC disease, BRCA1/2-driven cancers are usually characterized by good response to chemotherapy. However, even if OC patient undergoes complete surgical cytoreduction and potentially effective systemic therapy, the probability of the tumor relapse is high. This study aimed to compare some essential clinical features of OC relapses in hereditary vs. sporadic OC.
We identified 212 women with relapsed high-grade serous OC, who were treated in the N.N. Petrov Institute of Oncology within years 2000-2014, underwent complete primary (n = 113) or interval (n = 99) surgical debulking, and had available clinical data for analysis. 66 women were BRCA1/2 germ-line mutation carriers and 146 were mutation negative. Recurrences were classified according to anatomical location (local, regional, distant, marker), type (systemic or discrete) and pattern of spread.
As expected, median PFI (platinum-free interval) in BRCA1/2 carriers was longer as compared to sporadic cases (13.2 months vs. 8.0 months) [p < 0.001]. The proportion of OC cases with PFI > 12 months was significantly higher among BRCA1/2 carriers [38/66 (58%) vs. 51/146 (35%), p = 0.003]. There was no statistical difference in the frequency of distant relapses between these groups [10/66 (15%) vs. 31/146 (21%), p = 0.4]. Systemic recurrences (i.e., multiple lesions) occurred significantly more frequently in sporadic cases as compared to patients with BRCA1/2 mutation [98/144 (68%) vs. 30/60 (50%), p = 0.02] and were associated with shorter duration of PFI [p = 0.003]. The proportion of patients who could be subjected to the local treatment (locoregional discrete recurrence with lymphatic/transcoelomic spread) was higher among BRCA1/2 mutation carriers than non-carriers [29/66 (44%) vs. 45/146 (31%), p = 0.045].
BRCA1/2-driven OC are characterized by more favorable mode of relapse than sporadic high-grade serous ovarian cancers.
Clinical trial identification
Legal entity responsible for the study
N.N. Petrov Institute of Oncology.
Russian Science Foundation [grant number 14-25-00111].
All authors have declared no conflicts of interest.