Survival outcomes of metastatic breast cancer patients by germline BRCA1/2 status in a large multicenter real-world database |
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| Authors: | Audrey Mailliez Veronique D'Hondt Amelie Lusque Olivier Caron Luc Cabel Anthony Goncalves Marc Debled Laurence Gladieff Jean-Marc Ferrero Thierry Petit Marie Ange Mouret-Reynier Jean-Christophe Eymard Christelle Levy Lionel Uwer Marianne Leheurteur Isabelle Desmoulins Thomas Bachelot Jean-Sebastien Frenel Thibault de la Motte Rouge Gaëtane Simon William Jacot Suzette Delaloge |
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| Institution: | 1. Center Oscar Lambret, Lille, France;2. Institut régional du Cancer Montpellier/Val d'Aurelle, Montpellier, France;3. Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France;4. Institut Gustave Roussy, Villejuif, France;5. Institut Curie, Paris et Saint Cloud, France;6. Institut Paoli-Calmette, Marseille, France;7. Institut Bergonié, Bordeaux, France;8. Center Antoine Lacassagne, Nice, France;9. Center Paul Strauss, Strasbourg, France;10. Center Jean Perrin, Clermont Ferrand, France;11. Institut Jean Godinot, Reims, France;12. Center François Baclesse, Caen, France;13. Institut de Cancerologie de Lorraine, Vandoeuvre-lès-Nancy, France;14. Center Henri Becquerel, Rouen, France;15. Center Georges François Leclerc, Dijon, France;16. Center Léon Bérard, Lyon, France;17. Institut de cancérologie de l'Ouest, Nantes et Angers, France;18. Center Eugène Marquis, Rennes, France;19. Unicancer, Paris, France |
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| Abstract: | The outcomes and best treatment strategies for germline BRCA1/2 mutation (gBRCAm) carriers with metastatic breast cancer (MBC) remain uncertain. We compared the overall survival and the first line progression free survival (PFS1) of patients with a gBRCAm identified at initiation of first-line treatment with those of BRCA wild-type (WT) and not-tested (NT) individuals in the ESME real-world database of MBC patients between 2008 and 2016 (NCT03275311). Among the 20 624 eligible patients, 325 had a gBRCAm, 1138 were WT and 19 161 NT. Compared with WT, gBRCAm carriers were younger, and had more aggressive diseases. At a median follow-up of 50.5 months, median OS was 30.6 (95%CI: 21.9-34.3), 35.8 (95%CI: 32.2-37.8) and 39.3 months (95% CI: 38.3-40.3) in the gBRCAm, WT and NT subgroups, respectively. Median PFS1 was 7.9 (95%CI: 6.6-9.3), 7.8 (95%CI: 7.3-8.5) and 9.7 months (95%CI, 9.5-10.0). In the multivariable analysis conducted in the whole cohort, gBRCAm status had however no independent prognostic impact on OS and PFS1. Though, in the triple-negative subgroup, gBRCAm patients had better OS and PFS1 (HR vs WT = 0.76; 95%CI: 0.60-0.97; P = .027 and 0.69; 95% CI: 0.55-0.86; P = .001, respectively). In contrast, in patients with HR+/HER2 negative cancers, PFS1 appeared significantly and OS non significantly lower for gBRCAm carriers (PFS1: HR vs WT = 1.23; 95%CI: 1.03-1.46; P = .024; OS:HR = 1.22, 95% CI: 0.97-1.52, P = .089). In conclusion, gBRCA1/2 status appears to have divergent survival effects in MBC according to IHC subtype. |
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| Keywords: | germline BRCA mutation metastatic breast cancer real world survival |
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