Low testing rates and high BRCA prevalence: Poly (ADP-ribose) polymerase inhibitor use in Middle East BRCA/homologous recombination deficiency-positive cancer patients.

IF 2.6 Q3 ONCOLOGY World journal of clinical oncology Pub Date : 2024-07-24 DOI:10.5306/wjco.v15.i7.848
Naveed Syed, Ashish Vittalrao Chintakuntlawar, Deepti Vilasini, Aisha Mohamed Al Salami, Riad Al Hasan, Imrana Afrooz, Kanishka Uttam Chandani, Ashok Uttam Chandani, Aref Chehal
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Abstract

Background: Poly (ADP-ribose) polymerase inhibitors (PARPis) are approved as first-line therapies for breast cancer gene (BRCA)-positive, human epidermal growth factor receptor 2-negative locally advanced or metastatic breast cancer. They are also effective for new and recurrent ovarian cancers that are BRCA- or homologous recombination deficiency (HRD)-positive. However, data on these mutations and PARPi use in the Middle East are limited.

Aim: To assess BRCA/HRD prevalence and PARPi use in patients in the Middle East with breast/ovarian cancer.

Methods: This was a single-center retrospective study of 57 of 472 breast cancer patients tested for BRCA mutations, and 25 of 65 ovarian cancer patients tested for HRD. These adult patients participated in at least four visits to the oncology service at our center between August 2021 and May 2023. Data were summarized using descriptive statistics and compared using counts and percentages. Response to treatment was assessed using Response Evaluation Criteria in Solid Tumors criteria.

Results: Among the 472 breast cancer patients, 12.1% underwent BRCA testing, and 38.5% of 65 ovarian cancer patients received HRD testing. Pathogenic mutations were found in 25.6% of the tested patients: 26.3% breast cancers had germline BRCA (gBRCA) mutations and 24.0% ovarian cancers showed HRD. Notably, 40.0% of gBRCA-positive breast cancers and 66.0% of HRD-positive ovarian cancers were Middle Eastern and Asian patients, respectively. PARPi treatment was used in 5 (33.3%) gBRCA-positive breast cancer patients as first-line therapy (n = 1; 7-months progression-free), for maintenance (n = 2; > 15-months progression-free), or at later stages due to compliance issues (n = 2). Four patients (66.6%) with HRD-positive ovarian cancer received PARPi and all remained progression-free.

Conclusion: Lower testing rates but higher BRCA mutations in breast cancer were found. Ethnicity reflected United Arab Emirates demographics, with breast cancer in Middle Eastern and ovarian cancer in Asian patients.

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低检测率和高 BRCA 患病率:中东 BRCA/同源重组缺陷阳性癌症患者使用聚(ADP-核糖)聚合酶抑制剂的情况。
背景:聚(ADP-核糖)聚合酶抑制剂(PARPis)已被批准作为乳腺癌基因(BRCA)阳性、人类表皮生长因子受体 2 阴性的局部晚期或转移性乳腺癌的一线疗法。它们对 BRCA 或同源重组缺陷(HRD)阳性的新发和复发性卵巢癌也有效。目的:评估中东地区乳腺癌/卵巢癌患者的 BRCA/HRD 患病率和 PARPi 的使用情况:这是一项单中心回顾性研究,472 名乳腺癌患者中有 57 人接受了 BRCA 基因突变检测,65 名卵巢癌患者中有 25 人接受了 HRD 检测。这些成年患者在 2021 年 8 月至 2023 年 5 月期间至少在本中心肿瘤科就诊过四次。数据采用描述性统计进行总结,并采用计数和百分比进行比较。治疗反应采用实体瘤反应评估标准进行评估:472名乳腺癌患者中有12.1%接受了BRCA检测,65名卵巢癌患者中有38.5%接受了HRD检测。25.6%的受检患者发现了致病基因突变:26.3%的乳腺癌患者存在种系 BRCA(gBRCA)突变,24.0%的卵巢癌患者出现 HRD。值得注意的是,40.0%的gBRCA阳性乳腺癌和66.0%的HRD阳性卵巢癌患者分别是中东人和亚洲人。5例(33.3%)gBRCA阳性乳腺癌患者接受了PARPi治疗,包括一线治疗(1例;7个月无进展)、维持治疗(2例;>15个月无进展)或因依从性问题在后期阶段接受治疗(2例)。4名HRD阳性卵巢癌患者(66.6%)接受了PARPi治疗,均无进展:结论:乳腺癌的检测率较低,但 BRCA 突变率较高。种族反映了阿拉伯联合酋长国的人口结构,中东患者多患乳腺癌,亚洲患者多患卵巢癌。
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期刊介绍: The WJCO is a high-quality, peer reviewed, open-access journal. The primary task of WJCO is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of oncology. In order to promote productive academic communication, the peer review process for the WJCO is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCO are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in oncology. Scope: Art of Oncology, Biology of Neoplasia, Breast Cancer, Cancer Prevention and Control, Cancer-Related Complications, Diagnosis in Oncology, Gastrointestinal Cancer, Genetic Testing For Cancer, Gynecologic Cancer, Head and Neck Cancer, Hematologic Malignancy, Lung Cancer, Melanoma, Molecular Oncology, Neurooncology, Palliative and Supportive Care, Pediatric Oncology, Surgical Oncology, Translational Oncology, and Urologic Oncology.
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