Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Sci. 2021 Dec;112(12):5055-5067. doi: 10.1111/cas.15166. Epub 2021 Oct 25.
This study was performed to investigate the prevalence, clinical characteristics, and treatment response according to BRCA1 and BRCA2 (BRCA) mutations in Korean patients with epithelial ovarian cancer (EOC). Two-hundred and ninety-eight Korean women diagnosed with high-grade serous and/or endometrioid EOC from 2010 to 2015 were tested for germline and 86 specimens for somatic BRCA mutations, regardless of the family history. Clinical characteristics including survival outcomes were compared in patients with and without BRCA mutations (NCT02963688). A total of 43 different germline BRCA mutations were identified in 78 patients among 298 patients (26.2%). Somatic BRCA mutations were identified in 11 (12.8%) patients among patients without germline BRCA mutations. Haplotype analysis demonstrated no founder mutations in our Korean patient cohort. Insignificant differences in age at diagnosis, primary site, and residual disease after surgery were observed between patients with and without BRCA mutations. In multivariate analysis for overall survival (OS), the presence of BRCA mutation was significantly associated with OS (P = .049) in addition to platinum sensitivity (P < .001), indicating it is an independent prognostic factor for survival regardless of platinum sensitivity to first-line chemotherapy. In addition, a higher response rate to subsequent chemotherapy after recurrence was observed in EOC patients with BRCA mutations resulting in better OS. In the current study, the prevalence of BRCA mutations in Korean patients with EOC was higher than previously reported in other ethnic groups. We demonstrated characteristics and treatment response in Korean EOC patients with BRCA mutations. These findings may provide valuable information to be considered in future clinical trials including Asian patients.
本研究旨在探讨韩国上皮性卵巢癌(EOC)患者中 BRCA1 和 BRCA2(BRCA)突变的流行率、临床特征和治疗反应。2010 年至 2015 年期间,对 298 名经诊断患有高级别浆液性和/或子宫内膜样 EOC 的韩国女性进行了种系和 86 例体细胞 BRCA 突变检测,无论家族史如何。比较了有无 BRCA 突变的患者的临床特征(包括生存结局)(NCT02963688)。在 298 名患者中的 78 名患者中鉴定出 43 种不同的种系 BRCA 突变。在无种系 BRCA 突变的患者中,有 11 名(12.8%)患者鉴定出体细胞 BRCA 突变。单体型分析表明,我们的韩国患者队列中没有发现创始人突变。有无 BRCA 突变的患者在诊断时的年龄、原发部位和手术后残留疾病方面无显著差异。在总生存期(OS)的多变量分析中,除铂敏感性(P < 0.001)外,BRCA 突变的存在与 OS 显著相关(P = 0.049),表明它是独立的生存预后因素,与一线化疗的铂敏感性无关。此外,在复发后接受后续化疗的 EOC 患者中,BRCA 突变患者的反应率更高,OS 更好。在本研究中,韩国 EOC 患者的 BRCA 突变流行率高于其他种族群体的先前报道。我们展示了韩国 BRCA 突变 EOC 患者的特征和治疗反应。这些发现可能为未来包括亚洲患者在内的临床试验提供有价值的信息。