BRCA mutations

Limited information was identified to suggest that there are specific chemotherapy requirements for BRCA carriers.  Three studies that investigated the relationship between BRCA status and the effectiveness of chemotherapy, did not report on the impact of chemotherapy on overall or progression-free survival, treatment compliance, adverse events or quality of life, but did report on response to chemotherapy.

The study by Alsop et al published after the systematic search, investigated the frequency of BRCA mutations and patterns of treatment response in a prospectively ascertained population-based cohort of 1001 Australian women with newly diagnosed non mucinous ovarian cancer.61 Germ-line pathogenic BRCA1 or BRCA2 mutations were identified in 141 (14.1%) of the women. Of the 837 patients who received chemotherapy during primary treatment, 835 (99.8%) received a platinum-based regimen and 642 (76.9%) received carboplatin/paclitaxel.  Patients with BRCA1 and BRCA2 mutations were less likely to have disease progression within six months of the end of primary treatment compared with those not carrying mutations (14.9% vs. 31.7% respectively, p<0.001). Disease progression within six months of completing primary platinum-based chemotherapy has conventionally been associated with platinum resistance.61