Wunderle M, et al. - Experts studied the effect of germline BRCA1/2 mutations on pathological complete response and prognosis in patients receiving neoadjuvant systemic chemotherapy. Better responses to neoadjuvant chemotherapy in breast cancer were led by BRCA1/2 mutation status. Independently of BRCA1/2 mutation status, pathological complete response was the main predictor of disease-free survival and overall survival.

Methods

• Breast cancer patients were assessed for a BRCA1/2 mutation in clinical routine work and were treated with anthracycline-based or platinum-based neoadjuvant chemotherapy between 1997 and 2015.
• They identified these patients in the tumor registry of the Breast Center of the University of Erlangen (Germany).
• They performed logistic regression and Cox regression analyses to assess the relationship between BRCA1/2 mutation status, pathological complete response, disease-free survival, and overall survival.

Results

• In 355 patients, 43 had a mutation in BRCA1 (12.1%), and 16 in BRCA2 (4.5%).
• A cording to the data, pathological complete response (defined as “ypT0; ypN0”) was seen in 54.3% of BRCA1/2 mutation carriers, but only in 22.6% of non-carriers.
• Compared to non-carriers, BRCA1/2 carriers had an adjusted odds ratio of 2.48 (95% CI 1.26–4.91).
• They noted better disease-free survival and overall survival rates in patients who achieved a pathological complete response vs those who did not, regardless of BRCA1/2 mutation status.