Overall survival and clinical characteristics of BRCA mutation carriers with stage I/II pancreatic cancer Journal Article
| Authors: | Golan, T.; Sella, T.; O'Reilly, E. M.; Katz, M. H. G.; Epelbaum, R.; Kelsen, D. P.; Borgida, A.; Maynard, H.; Kindler, H.; Friedmen, E.; Javle, M.; Gallinger, S. |
| Article Title: | Overall survival and clinical characteristics of BRCA mutation carriers with stage I/II pancreatic cancer |
| Abstract: | Background: BRCA1/BRCA2 germ line (GL) mutation carriers with pancreatic adenocarcinoma (PDAC) may have distinct outcomes. We recently described an apparent more favourable prognosis of surgically resected BRCA-associated PDAC patients in a single-arm, uncontrolled, retrospective study. However, the prognostic impact of GL BRCA1/2 mutations in surgically resected PDAC has not been compared with a matched control population. Methods: A larger multi-centre, case-control retrospective analysis was performed. Cases were patients with surgically resected, BRCA1/2-associated PDAC from 2004 to 2013. Controls included surgically resected PDAC cases treated during the same time period that were either BRCA non-carriers, or had no family history of breast, ovarian or pancreatic cancers. Cases and controls were matched by: age at diagnosis (within +/- 5-year period) and institution. Demographics, clinical history, overall survival (OS) and disease-free survival (DFS) were abstracted from patient records. Statistical comparisons were assessed using chi(2)-and Fisher's exact test, and median DFS/OS using Kaplan-Meier method and log-rank testing. Results: Twenty-five patients with BRCA1-(n = 4) or BRCA2 (N = 21)-associated resectable PDAC were identified. Mean age was 55.7 years (range, 34-78 years), 48% (n = 12) were females and 76% (n = 19) were Jewish. Cases were compared (1 : 2) with 49 resectable PDAC controls, and were balanced for age, ethnicity and other relevant clinical and pathological features. BRCAassociated PDAC patients received neoadjuvant, or adjuvant platinum-based treatment more frequently than controls (7 out of 8 vs 6 out of 14) and (7 out of 21 vs 3 out of 44), respectively. No significant difference in median OS (37.06 vs 38.77 months, P = 0.838) and in DFS (14.3 vs 12.0 months, P = 0.303) could be demonstrated between cases and controls. A trend to increased DFS was observed among BRCA-positive cases treated with neoadjuvant/adjuvant platinum-containing regimens (n = 10) compared with similarly treated controls (n = 7) (39.1 vs 12.4 months, P = 0.255). Conclusions: In this retrospective analysis, the prognosis of surgically resectable BRCA-associated PDAC is no different than that of sporadic PDAC from the same institution. The role of platinum-based adjuvant therapy in this setting requires prospective investigation. |
| Keywords: | gemcitabine; adenocarcinoma; pancreatic cancer; brca2; women; ovarian-cancer; case-control study; improvement; brca 1; dfs; 6174delt; os |
| Journal Title: | British Journal of Cancer |
| Volume: | 116 |
| Issue: | 6 |
| ISSN: | 0007-0920 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2017-03-14 |
| Start Page: | 697 |
| End Page: | 702 |
| Language: | English |
| ACCESSION: | WOS:000397436100004 |
| DOI: | 10.1038/bjc.2017.19 |
| PROVIDER: | wos |
| PMCID: | PMC5355924 |
| PUBMED: | 28183138 |
| Notes: | Article -- Source: Wos |
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