Brain metastasis in epithelial ovarian cancer by BRCA1/2 mutation status Journal Article


Authors: Stasenko, M.; Cybulska, P.; Feit, N.; Makker, V.; Konner, J.; O'Cearbhaill, R. E.; Alektiar, K. M.; Beal, K.; Gardner, G. J.; Long Roche, K. C.; Sonoda, Y.; Chi, D. S.; Zivanovic, O.; Leitao, M. M. Jr; Cadoo, K. A.; Tew, W. P.
Article Title: Brain metastasis in epithelial ovarian cancer by BRCA1/2 mutation status
Abstract: Objective: To evaluate clinical outcomes of patients with BRCA-associated ovarian cancer who developed brain metastases (BM). Methods: Patients with epithelial ovarian, fallopian tube, and primary peritoneal cancer (EOC) and BM, treated at a single institution from 1/1/2008–7/1/2018, were identified from two institutional databases. Charts and medical records were retrospectively reviewed for clinical characteristics and germline BRCA mutation status. Appropriate statistics were used. Results: Of 3649 patients with EOC, 91 had BM (2.5%). Germline mutation status was available for 63 (69%) cases; 21 (35%) of these harbored a BRCA1/2 mutation (15 BRCA1, 6 BRCA2). Clinical characteristics were similar between groups. BM were diagnosed at a median of 31 months (95% CI, 22.6–39.4) in BRCA-mutated (mBRCA) and 32 months (95% CI, 23.7–40.3) in wild-type BRCA (wtBRCA) (p = 0.78) patients. Brain metastases were the only evidence of disease at time of BM diagnoses in 48% (n = 10) mBRCA and 19% (n = 8) wtBRCA (p = 0.02) patients. There was no difference in treatment of BM by mutation status (p = 0.84). Survival from time of BM diagnosis was 29 months (95%CI, 15.5–42.5) in mBRCA and 9 months (95% CI, 5.5–12.5) in wtBRCA patients, with an adjusted hazard ratio (HR) of 0.53, p = 0.09; 95% CI, 0.25–1.11. HR was adjusted for presence of systemic disease at time of BM diagnosis. Conclusion: This is the largest study to date comparing outcomes in patients with EOC and BM by mutation status. mBRCA patients were more likely to have isolated BM, which may be a factor in their long survival. This supports the pursuit of aggressive treatment for mBRCA EOC patients with BM. Additional studies examining the correlation of BRCA mutational status with BM are warranted. © 2019 Elsevier Inc.
Keywords: ovarian cancer; brain metastasis; brca mutation
Journal Title: Gynecologic Oncology
Volume: 154
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2019-07-01
Start Page: 144
End Page: 149
Language: English
DOI: 10.1016/j.ygyno.2019.05.004
PUBMED: 31113680
PROVIDER: scopus
PMCID: PMC6589378
DOI/URL:
Notes: Article -- Export Date: 1 July 2019 -- Source: Scopus
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MSK Authors
  1. Ginger J Gardner
    204 Gardner
  2. Vicky Makker
    140 Makker
  3. Dennis S Chi
    589 Chi
  4. Kaled M Alektiar
    286 Alektiar
  5. Yukio Sonoda
    365 Sonoda
  6. Mario Leitao
    434 Leitao
  7. Jason Konner
    123 Konner
  8. Kathryn Beal
    188 Beal
  9. Oliver Zivanovic
    207 Zivanovic
  10. Kara Christine Long
    138 Long
  11. William P Tew
    197 Tew
  12. Karen Anne Cadoo
    100 Cadoo