The efficacy of taxane chemotherapy for metastatic breast cancer in BRCA1 and BRCA2 mutation carriers

被引:68
作者
Kriege, Mieke [1 ]
Jager, Agnes [1 ]
Hooning, Maartje J. [1 ]
Huijskens, Elisabeth [1 ]
Blom, Jannet [1 ]
van Deurzen, Carolien H. M. [2 ]
Bontenbal, Marijke [1 ]
Collee, J. Margriet [3 ]
Menke-Pluijmers, Marian B. E. [4 ]
Martens, John W. M. [1 ]
Seynaeve, Caroline [1 ]
机构
[1] Erasmus MC Daniel den Hoed Canc Ctr, Rotterdam Family Canc Clin, Dept Med Oncol, NL-3075 EA Rotterdam, Netherlands
[2] Erasmus MC, Family Canc Clin, Dept Pathol, Rotterdam, Netherlands
[3] Erasmus MC, Family Canc Clin, Dept Clin Genet, Rotterdam, Netherlands
[4] Erasmus MC Daniel den Hoed Canc Ctr, Family Canc Clin, Dept Surg Oncol, NL-3075 EA Rotterdam, Netherlands
关键词
BRCA1; BRCA2; breast cancer; metastatic disease; docetaxel; paclitaxel; NEOADJUVANT CHEMOTHERAPY; EXPRESSION; INHIBITION; DOCETAXEL; SURVIVAL; PREDICT; WOMEN;
D O I
10.1002/cncr.26351
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: We assessed the efficacy of taxane chemotherapy in BRCA1- and BRCA2-associated patients compared with sporadic metastatic breast cancer patients. METHODS: Response rates (RRs) to and progression-free survival (PFS) after taxane chemotherapy of 35 BRCA1-associated and 13 BRCA2-associated metastatic breast cancer patients were compared with those outcomes in 95 matched (1: 2) sporadic patients. Matching was performed for age at and year of diagnosis of primary breast cancer, year of metastatic disease, and line of therapy (first vs second or third). RESULTS: Among BRCA1-associated patients, the RR was worse (objective response [OR], 23% vs 38%; progressive disease [PD], 60% vs 19%; P < 0.001); and the median PFS shorter (2.2 vs 4.9 months; P = 0.04) compared with sporadic patients. In the subgroup of hormone receptor (HRec)-negative patients, BRCA1-associated patients (n = 20) had a worse RR (OR, 20% vs 42%, respectively; PD, 70% vs 26%, respectively; P = 0.03) and a shorter PFS (1.8 vs 3.8 months; P = 0.004) compared with sporadic patients (n = 19). These outcomes in HRec-positive patients were similar in BRCA1-associated (n = 11) and sporadic (n = 61) patients (OR, 36% vs 38%; PD, 28% vs 20%; median PFS, both 5.7 months). In BRCA2-associated patients, who were mainly HRec-positive, the OR was higher than in sporadic patients (89% vs 38%, respectively; P = 0.02), whereas the median PFS was not significantly different (7.1 vs 5.7 months, respectively). CONCLUSIONS: BRCA1-associated, HRec-negative metastatic breast cancer patients were less sensitive to taxane chemotherapy than sporadic HRec-negative patients. HRec-positive BRCA1- and BRCA2-associated patients had a sensitivity to taxane chemotherapy similar to that of sporadic patients. Cancer 2012;118:899-907. (C) 2011 American Cancer Society.
引用
收藏
页码:899 / 907
页数:9
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