Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centre, Rotterdam, Netherlands.
Cancer. 2012 Feb 15;118(4):899-907. doi: 10.1002/cncr.26351. Epub 2011 Jul 14.
We assessed the efficacy of taxane chemotherapy in BRCA1- and BRCA2-associated patients compared with sporadic metastatic breast cancer patients.
Response rates (RRs) to and progression-free survival (PFS) after taxane chemotherapy of 35 BRCA1-associated and 13 BRCA2-associated metastatic breast cancer patients were compared with those outcomes in 95 matched (1:2) sporadic patients. Matching was performed for age at and year of diagnosis of primary breast cancer, year of metastatic disease, and line of therapy (first vs second or third).
Among BRCA1-associated patients, the RR was worse (objective response [OR], 23% vs 38%; progressive disease [PD], 60% vs 19%; P < 0.001); and the median PFS shorter (2.2 vs 4.9 months; P = 0.04) compared with sporadic patients. In the subgroup of hormone receptor (HRec)-negative patients, BRCA1-associated patients (n = 20) had a worse RR (OR, 20% vs 42%, respectively; PD, 70% vs 26%, respectively; P = 0.03) and a shorter PFS (1.8 vs 3.8 months; P = 0.004) compared with sporadic patients (n = 19). These outcomes in HRec-positive patients were similar in BRCA1-associated (n = 11) and sporadic (n = 61) patients (OR, 36% vs 38%; PD, 28% vs 20%; median PFS, both 5.7 months). In BRCA2-associated patients, who were mainly HRec-positive, the OR was higher than in sporadic patients (89% vs 38%, respectively; P = 0.02), whereas the median PFS was not significantly different (7.1 vs 5.7 months, respectively).
BRCA1-associated, HRec-negative metastatic breast cancer patients were less sensitive to taxane chemotherapy than sporadic HRec-negative patients. HRec-positive BRCA1- and BRCA2-associated patients had a sensitivity to taxane chemotherapy similar to that of sporadic patients.
我们评估了紫杉烷化疗在 BRCA1 和 BRCA2 相关患者中的疗效，并与散发性转移性乳腺癌患者进行了比较。
比较了 35 例 BRCA1 相关和 13 例 BRCA2 相关转移性乳腺癌患者接受紫杉烷化疗后的缓解率（RR）和无进展生存期（PFS），并与 95 例匹配的（1:2）散发性患者的结局进行了比较。匹配因素为原发性乳腺癌的诊断年龄和诊断年份、转移性疾病的诊断年份以及治疗线数（一线、二线或三线）。
BRCA1 相关患者的 RR 更差（客观缓解 [OR]，23% vs 38%；疾病进展 [PD]，60% vs 19%；P < 0.001），中位 PFS 更短（2.2 个月 vs 4.9 个月；P = 0.04），与散发性患者相比。在激素受体（HRec）阴性患者亚组中，BRCA1 相关患者（n = 20）的 RR 更差（OR，分别为 20% vs 42%；PD，分别为 70% vs 26%；P = 0.03），PFS 更短（1.8 个月 vs 3.8 个月；P = 0.004），与散发性患者（n = 19）相比。HRec 阳性患者中 BRCA1 相关（n = 11）和散发性（n = 61）患者的这些结局相似（OR，分别为 36% vs 38%；PD，分别为 28% vs 20%；中位 PFS，均为 5.7 个月）。BRCA2 相关患者主要为 HRec 阳性，OR 高于散发性患者（分别为 89% vs 38%；P = 0.02），但中位 PFS 无显著差异（分别为 7.1 个月 vs 5.7 个月）。
与散发性 HRec 阴性患者相比，BRCA1 相关、HRec 阴性转移性乳腺癌患者对紫杉烷化疗的敏感性较低。HRec 阳性的 BRCA1 和 BRCA2 相关患者对紫杉烷化疗的敏感性与散发性患者相似。
