Impact of BRCA1/2 Mutations on the Efficacy of Secondary Cytoreductive Surgery

Estati, Felipe Leonardo; Pirolli, Rafaela; Alencar, Viviane Teixeira Loiola de; Ribeiro, Adriana Regina G.; Formiga, Maria Nirvana da Cruz; Torrezan, Giovana Tardin; Carraro, Dirce Maria; Guimarães, Andréa Paiva Gadêlha; Baiocchi, Glauco; Costa, Alexandre André Balieiro Anastácio da

doi:10.1245/s10434-020-09366-w

Cited by 10 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is in line with Estati et al, who also validated BRCAmut status to significantly promote complete macroscopic resection in recurrence. 32 The rate of complete secondary resection in their study was 89.5% in the BRCAmut group and 65.2% in the BRCAwt group. 32 This indicates that especially patients with BRCAmut rOC disease show altered tumor biology and consecutively treatment response that cannot just be explained by younger age.…”

Section: Results In the Context Of Published Literaturementioning

confidence: 85%

“…32 The rate of complete secondary resection in their study was 89.5% in the BRCAmut group and 65.2% in the BRCAwt group. 32 This indicates that especially patients with BRCAmut rOC disease show altered tumor biology and consecutively treatment response that cannot just be explained by younger age. Therefore, we suggest that BRCA mutation status should be taken into account as a parameter when selecting patients eligible for secondary debulking surgery aiming for complete macroscopic resection.…”

Section: Results In the Context Of Published Literaturementioning

confidence: 85%

See 1 more Smart Citation

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium

et al. 2022

View full text Add to dashboard Cite

Background This study seeks to evaluate the impact of breast cancer (BRCA) gene status on tumor dissemination pattern, surgical outcome and survival in a multicenter cohort of paired primary ovarian cancer (pOC) and recurrent ovarian cancer (rOC). Patients and Methods Medical records and follow-up data from 190 patients were gathered retrospectively. All patients had surgery at pOC and at least one further rOC surgery at four European high-volume centers. Patients were divided into one cohort with confirmed mutation for BRCA1 and/or BRCA2 (BRCAmut) and a second cohort with BRCA wild type or unknown (BRCAwt). Patterns of tumor presentation, surgical outcome and survival data were analyzed between the two groups. Results Patients with BRCAmut disease were on average 4 years younger and had significantly more tumor involvement upon diagnosis. Patients with BRCAmut disease showed higher debulking rates at all stages. Multivariate analysis showed that only patient age had significant predictive value for complete tumor resection in pOC. At rOC, however, only BRCAmut status significantly correlated with optimal debulking. Patients with BRCAmut disease showed significantly prolonged overall survival (OS) by 24.3 months. Progression-free survival (PFS) was prolonged in the BRCAmut group at all stages as well, reaching statistical significance during recurrence. Conclusions Patients with BRCAmut disease showed a more aggressive course of disease with earlier onset and more extensive tumor dissemination at pOC. However, surgical outcome and OS were significantly better in patients with BRCAmut disease compared with patients with BRCAwt disease. We therefore propose to consider BRCAmut status in regard to patient selection for cytoreductive surgery, especially in rOC.

show abstract

Section: Results In the Context Of Published Literaturementioning

confidence: 85%

Section: Results In the Context Of Published Literaturementioning

confidence: 85%

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Moreover, our previous data have suggested a potential benefit of SCS for DFS compared with only chemotherapy, irrespective of BRCA status, in patients who are primarily not treated with a PARP inhibitor. Yet, BRCA-mutated cases were more likely to receive complete secondary cytoreduction compared with wild-type cases (89.5% vs. 65.2%; p=0.047) [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

The value of PET/CT for cytoreductive surgery selection in recurrent ovarian carcinoma

et al. 2023

Self Cite

View full text Add to dashboard Cite

Objective To evaluate the value of positron emission tomography/computed tomography (PET/CT) in predicting no residual disease (NRD) after secondary cytoreductive surgery (SCS) compared with MSK criteria, the iMODEL, and the AGO score. Methods We analyzed 112 patients with platinum-sensitive ovarian carcinoma who underwent SCS. We excluded patients for whom PET/CT was not performed, those without sufficient data, and who received chemotherapy before SCS. Ultimately, 69 patients were included. Results Variables that correlated with NRD were peritoneal carcinomatosis index (odds ratio [OR]=0.91; 95% confidence interval [CI]=0.83–0.99; p=0.044), European Cooperative Oncology Group Performance Status (ECOG) 0 (OR=8.0; 95% CI=1.34–47.5; p=0.022), and ≤2 lesions by PET/CT (OR=4.36; 95% CI=1.07–17.7; p=0.039). Of the patients with ≤2 lesions by PET/CT, 48 (92.3%) underwent complete SCS. The sensitivity, positive predictive value, negative predictive value, and accuracy of PET/CT for NRD were 85.7%, 92.3%, 33.3%, and 81.2%, respectively. NRD was achieved after fulfilling the MSK criteria, iMODEL and AGO Score in 89.1%, 88.1% and 85.9%, respectively. The accuracy of the MSK criteria, iMODEL, and AGO score in predicting NRD was 87%, 83.3%, and 77.3%, respectively. The PET/CT findings agreed well with the AGO score and iMODEL. The addition of PET/CT to these models increased the NRD rates (92.2%, 91.8%, and 89.4% for MSK+PET/CT, iMODEL+PET/CT, and AGO+PET/CT, respectively), but lowered their accuracy. Conclusion We observed NRD in 92.3% of patients with ≤2 lesions by PET/CT, with an accuracy of 81.2%. PET/CT did not increase the accuracy of the MSK criteria, iMODEL, or AGO score models.

show abstract

“…Subsequently, their further study demonstrated that SCS increases the TFST and post-recurrence survival in platinum-sensitive ROC patients with BRCA mut candidates for olaparib maintenance after platinum-based chemotherapy ( 40 , 41 ). Conversely, another study showed a benefit of SCS irrespective of the BRCA1 / BRCA2 status among patients mostly not treated with PARP inhibitors ( 42 ). Besides, a phase II multicenter RCT (SGOG SOC-3 Study, NCT03983226) was conducted to answer the question of whether patients can benefit from a potential CGR combined with niraparib maintenance in platinum-sensitive secondary recurrent patients.…”

Section: Limitations Of the Current Prediction Modelsmentioning

confidence: 99%

Prediction Models for Complete Resection in Secondary Cytoreductive Surgery of Patients With Recurrent Ovarian Cancer

Jiang

2021

Front. Oncol.

View full text Add to dashboard Cite

The most advanced epithelial ovarian cancer develops recurrent disease despite maximal surgical cytoreduction and adjuvant platinum-based chemotherapy. Treatment with secondary cytoreductive surgery (SCS) combined with chemotherapy or with chemotherapy alone for patients with platinum-sensitive recurrent ovarian cancer (ROC) is currently under heated discussion. Encouragingly, the results of the AGO DESKTOP III Study and the SOC1/SGOG-OV2 trial, which have been published recently, showed a striking advantage in terms of overall survival (OS) and progression-free survival (PFS) of ROC patients undergoing SCS compared to chemotherapy alone; moreover, a benefit of SCS exclusively for patients with complete gross resection (CGR) was particularly highlighted. CGR is considered the ultimate goal of SCS, on condition that the balance between maximal survival gain and minimal operative morbidity is maintained. Several models have been proposed to predict the rate of CGR, such as the MSK criteria, the AGO score, and the Tian model, over the last 15 years. This summary is mainly about the several previously published prediction models for CGR in SCS of ROC patients and discusses the effectiveness and limitations of these prediction models.

show abstract

Impact of BRCA1/2 Mutations on the Efficacy of Secondary Cytoreductive Surgery

Cited by 10 publications

References 29 publications

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer: A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium

The value of PET/CT for cytoreductive surgery selection in recurrent ovarian carcinoma

Prediction Models for Complete Resection in Secondary Cytoreductive Surgery of Patients With Recurrent Ovarian Cancer

Contact Info

Product

Resources

About