Association of Genetic Testing Results With Mortality Among Women With Breast Cancer or Ovarian Cancer
| Autor: | Kevin C. Ward, Paul Abrahamse, Scarlett Lin Gomez, Ann S. Hamilton, Allison W. Kurian, Irina Bondarenko, Monica Morrow, Jonathan S. Berek, Timothy P. Hofer, Steven J. Katz, Dennis Deapen |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment Genes BRCA2 Population Genes BRCA1 Breast Neoplasms Triple Negative Breast Neoplasms Breast cancer Internal medicine Surveillance Epidemiology and End Results medicine Humans Genetic Predisposition to Disease Genetic Testing education Germ-Line Mutation Genetic testing Ovarian Neoplasms Chemotherapy education.field_of_study medicine.diagnostic_test business.industry Hazard ratio Cancer Articles medicine.disease Female Ovarian cancer business |
| Zdroj: | J Natl Cancer Inst |
| ISSN: | 1460-2105 0027-8874 |
| DOI: | 10.1093/jnci/djab151 |
| Popis: | Background Breast cancer and ovarian cancer patients increasingly undergo germline genetic testing. However, little is known about cancer-specific mortality among carriers of a pathogenic variant (PV) in BRCA1/2 or other genes in a population-based setting. Methods Georgia and California Surveillance Epidemiology and End Results (SEER) registry records were linked to clinical genetic testing results. Women were included who had stages I-IV breast cancer or ovarian cancer diagnosed in 2013-2017, received chemotherapy, and were linked to genetic testing results. Multivariable Cox proportional hazard models were used to examine the association of genetic results with cancer-specific mortality. Results 22 495 breast cancer and 4320 ovarian cancer patients were analyzed, with a median follow-up of 41 months. PVs were present in 12.7% of breast cancer patients with estrogen and/or progesterone receptor-positive, HER2-negative cancer, 9.8% with HER2-positive cancer, 16.8% with triple-negative breast cancer, and 17.2% with ovarian cancer. Among triple-negative breast cancer patients, cancer-specific mortality was lower with BRCA1 (hazard ratio [HR] = 0.49, 95% confidence interval [CI] = 0.35 to 0.69) and BRCA2 PVs (HR = 0.60, 95% CI = 0.41 to 0.89), and equivalent with PVs in other genes (HR = 0.65, 95% CI = 0.37 to 1.13), vs noncarriers. Among ovarian cancer patients, cancer-specific mortality was lower with PVs in BRCA2 (HR = 0.35, 95% CI = 0.25 to 0.49) and genes other than BRCA1/2 (HR = 0.47, 95% CI = 0.32 to 0.69). No PV was associated with higher cancer-specific mortality. Conclusions Among breast cancer and ovarian cancer patients treated with chemotherapy in the community, BRCA1/2 and other gene PV carriers had equivalent or lower short-term cancer-specific mortality than noncarriers. These results may reassure newly diagnosed patients, and longer follow-up is ongoing. |
| Databáze: | OpenAIRE |
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