Department of Genetics andPathology, International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland.
J Clin Oncol. 2010 Jan 20;28(3):375-9. doi: 10.1200/JCO.2008.20.7019. Epub 2009 Dec 14.
To estimate the rate of pathologic complete response (pCR) to neoadjuvant chemotherapy in BRCA1 mutation carriers according to chemotherapy regimen.
From a registry of 6,903 patients, we identified 102 women who carried a BRCA1 founder mutation and who had been treated for breast cancer with neoadjuvant chemotherapy. Pathologic complete response was evaluated using standard criteria.
Twenty-four (24%) of the 102 BRCA1 mutation carriers experienced a pCR. The response rate varied widely with treatment: a pCR was observed in one (7%) of 14 women treated with cyclophosphamide, methotrexate, and fluorouracil (CMF); in two (8%) of 25 women treated with doxorubicin and docetaxel (AT); in 11 (22%) of 51 women treated with doxorubicin and cyclophosphamide (AC) or fluorouracil, doxorubicin, and cyclophosphamide (FAC), and in 10 (83%) of 12 women treated with cisplatin.
A low rate of pCR was observed in women with breast cancer and a BRCA1 mutation who were treated with AT or CMF. A high rate of pCR was seen after treatment with cisplatin. An intermediate rate of PCR was associated with AC or FAC. The relative benefits of AC and platinum therapy need to be confirmed through follow-up of this and other cohorts.
根据化疗方案，估计 BRCA1 突变携带者新辅助化疗的病理完全缓解（pCR）率。
我们从一个包含 6903 名患者的登记处中，确定了 102 名携带 BRCA1 种系突变并接受新辅助化疗治疗乳腺癌的女性。使用标准标准评估病理完全缓解。
102 名 BRCA1 突变携带者中有 24 名（24%）经历了 pCR。治疗的反应率差异很大：14 名接受环磷酰胺、甲氨蝶呤和氟尿嘧啶（CMF）治疗的女性中，有 1 名（7%）出现了 pCR；25 名接受阿霉素和多西紫杉醇（AT）治疗的女性中有 2 名（8%）；51 名接受阿霉素和环磷酰胺（AC）或氟尿嘧啶、阿霉素和环磷酰胺（FAC）治疗的女性中有 11 名（22%），12 名接受顺铂治疗的女性中有 10 名（83%）出现了 pCR。
在接受 AT 或 CMF 治疗的乳腺癌和 BRCA1 突变的女性中，pCR 率较低。接受顺铂治疗后，pCR 率较高。AC 或铂类治疗的 pCR 率中等。AC 和铂类治疗的相对益处需要通过对本队列和其他队列的随访来证实。
