Abstract 5077
Background
Women with OC due to an underlying BRCA mutation (BRCAm) are known to have enhanced responses to platinum and PLD, but their relative response rates to wpac are unclear. Both PLD and wpac are commonly used in women with PROC. Our aim was to assess the response rates to both agents, stratified by BRCAm staus.
Methods
Women with PR OC treated at The Royal Marsden Hospital between 2007 and 2017 with known BRCAm status were identified from the electronic patient record. Included patients underwent a minimum of 3 cycles and radiological restaging for inclusion. The primary endpoint was radiological response (RR) by BRCA status - BRCAm or BRCA wildtype (WT). Secondary endpoints were clinical benefit rate (CBR), CA-125 response, and line of treatment as a predictor of response.
Results
231 pt were identified, 38 BRCAm, 193 WT; median age 58 yrs (36-88) BRCAm, 62 yrs (44-85) WT. Histology was 90% HGS, 4% endometroid, 3% clear cell, 1% mucinous, 2% other. Overall 102 (44%) were treated with PLD; 129 (56%) received wpac with RR 14% PLD and 38% wpac; CBR of 49% PLD and 83% wpac (p = 0.01). When stratified by BRCAm, RR to PLD was 28% (BRCAm) vs 13% (WT; p = 0.01); and wpac 37% (BRCAm) vs 38% (WT, ns). CBR was 64% (BRCAm) vs 48% (WT) with PLD (p = 0.02) and 81% vs 83% with wpac (WT, ns). GCIG CA-125 responses were present in 110/231 (48%) – 24 PLD and 86 wpac, for CA-125 RR of 24% and 66% respectively (p < 0.001). Choice of first line treatment was PLD (49%) and wpac (51%); use in 2nd line was 44% and 56% respectively. Line of treatment was not an independent predictor of RR.
Conclusions
Within the limits of a retrospective audit, BRCAm carriers had significantly higher RR to PLD than WT patients; with equivalent responses to wpac. Wpac may be a preferred choice over PLD in BRCA WT patients with PROC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
733 - Clinical experience: ramucirumab with FOLFIRI/XELIRI as a second line for patients with metastatic gastric cancer
Presenter: Tatiana Titova
Session: Poster Display session 2
Resources:
Abstract
2186 - Efficacy and safety of apatinib for the treatment of AFP-producing gastric cancer
Presenter: Ningning Li
Session: Poster Display session 2
Resources:
Abstract
3172 - Apatinib in combination with docetaxol and S1 chemotherapy in the first line treatment of metastatic gastric cancer
Presenter: Ling Xia
Session: Poster Display session 2
Resources:
Abstract
3982 - Parameters of local cellular immunity in metastatic gastric cancer
Presenter: Aleksandr Sagakyants
Session: Poster Display session 2
Resources:
Abstract
5102 - Germline pathogenic mutations in Chinese patients with gastric cancer identified by next-generation sequencing (NGS)
Presenter: Xiaotian Zhang
Session: Poster Display session 2
Resources:
Abstract
5012 - Inhibition of the PI3K pathway in HER2-positive gastric cancer
Presenter: Sinead Toomey
Session: Poster Display session 2
Resources:
Abstract
4803 - Investigation on gastric cancer susceptibility genes in Chinese early-onset diffuse gastric cancer
Presenter: Yi Feng
Session: Poster Display session 2
Resources:
Abstract
4778 - A correlation analysis between survival rate and the characteristic gene of gastric cancer based on bioinformatics analysis
Presenter: Yi-wen Zhang
Session: Poster Display session 2
Resources:
Abstract
4805 - Phase I study of apatinib combined with POF (paclitaxel plus FOLFOX) in patients (pts) with treatment-naïve advanced gastric cancer (TNAGC)
Presenter: Rongbo LIN
Session: Poster Display session 2
Resources:
Abstract
3248 - Second-line palliative systemic treatment for synchronous metastatic esophagogastric cancer: a population-based study
Presenter: Willemieke Dijksterhuis
Session: Poster Display session 2
Resources:
Abstract