For BRCA germline mutation carriers, better survival seen with platinum-based chemotherapy
WEDNESDAY, May 30, 2018 (HealthDay News) — BRCA1/BRCA2 germline mutation carriers with pancreatic ductal adenocarcinoma (PDAC) have worse survival after resection, according to a study published in the April issue of the Journal of the American College of Surgeons.
Alex B. Blair, M.D., from Johns Hopkins Medical Institutions in Baltimore, and colleagues performed targeted next-generation sequencing to identify BRCA1/BRCA2 germline mutations in resected sporadic PDAC cases from 2000 to 2015. Germline BRCA mutation carriers (four patients with BRCA1 and 18 with BRCA2) were matched to those with BRCA1/BRCA2 wild-type genes (105 patients). Overall survival (OS) and disease-free survival (DFS) were compared between the cohorts.
The researchers found that, compared with matched wild-type controls, the BRCA1/BRCA2 mutations correlated with significantly inferior median OS (20.2 versus 27.8 months) and DFS (8.4 versus 16.7 months). There were significant independent correlations for BRCA1/BRCA2 mutation, positive margin status, and lack of adjuvant therapy with worse survival in multivariable analysis (hazard ratios, 2.10, 1.72, and 2.38, respectively). Having had platinum-based adjuvant chemotherapy correlated with significantly better survival than alternative chemotherapy or no adjuvant chemotherapy within the BRCA1/BRCA2 mutated group (31.0 versus 17.8 and 9.3 months, respectively).
“Carriers of BRCA1/BRCA2 mutation with sporadic PDAC had a worse survival after pancreatectomy than their BRCA wild-type counterparts,” the authors write. “However, platinum-based chemotherapy regimens were associated with markedly improved survival in patients with BRCA1/BRCA2 mutations, with survival differences no longer appreciated with wild-type patients.”
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