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- Title
Outcomes of patients with HER2-negative metastatic breast cancer after platinum- and non-platinum-based first-line chemotherapy among patients with and without pathogenic germline BRCA1/2 mutations.
- Authors
Jacot, William; Lusque, Amélie; Vicier, Cécile; Mailliez, Audrey; de La Motte Rouge, Thibault; Cabel, Luc; Levy, Christelle; Patsouris, Anne; Desmoulins, Isabelle; Uwer, Lionel; Thery, Jean-Christophe; Robain, Mathieu; Caron, Olivier; Tredan, Olivier; Filleron, Thomas; Frenel, Jean-Sébastien; Delaloge, Suzette
- Abstract
<bold>Background: </bold>The efficacy and added benefit of platinum-based chemotherapy (PtCT) for metastatic breast cancer (MBC) remain unclear in patients with and without germline BRCA1 or BRCA2 mutations (gBRCA1/2m and gBRCA1/2wt, respectively).<bold>Methods: </bold>We selected from the French national real-world multicentre ESME cohort (2008-2016) all patients with HER2-negative MBC with known gBRCA1/2 status at first-line chemotherapy initiation. Using multivariable Cox models, we compared the outcome (progression-free (PFS) and overall survival (OS)) of first-line PtCT and non-PtCT regimens based on the patients' gBRCA1/2 status and tumour subtype.<bold>Results: </bold>Patients who received PtCT had more aggressive tumour features. In the multivariable analysis, first-line PtCT was associated with better adjusted PFS and OS in gBRCA1/2m carriers (N = 300), compared with non-PtCT (HR 0.54, 95% CI 0.4-0.73, P < 0.001, and HR 0.70, 95% CI 0.49-0.99, P = 0.047, respectively). Conversely, outcomes were similar in gBRCA1/2wt patients (N = 922) treated with PtCT and non-PtCT, whatever the tumour subtype. Landmark analyses at months 3 and 6 post treatment initiation supported these results.<bold>Conclusions: </bold>In this pre-PARP inhibitor real-world cohort, PFS and OS were better after PtCT than non-PtCT in patients with gBRCA1/2m, but not in those with gBRCA1/2wt. These results emphasise the need of early gBRCA1/2 testing in patients with MBC.<bold>Clinical Trial Number: </bold>NCT03275311.
- Subjects
THERAPEUTIC use of antineoplastic agents; PROTEINS; GERM cells; BREAST tumors; GENETIC mutation; PLATINUM
- Publication
British Journal of Cancer, 2022, Vol 127, Issue 11, p1963
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-022-02003-1