Frequency of brain metastases in patients with locally advanced triple negative breast cancer after neoadjuvant platinum-based chemotherapy: Impact of BRCA1/2 mutations.

Authors

null

Elena Glazkova

N.N. Blokhin National Medical Research Center of Oncology, St. Petersburg, Russian Federation

Elena Glazkova , Marina Stenina , Mona A. Frolova , Ekaterina Ignatova , Alexey Rumyantsev , Alexander Petrovsky , Sergei Tjulandin

Organizations

N.N. Blokhin National Medical Research Center of Oncology, St. Petersburg, Russian Federation, Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology"оf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russian Federation, Federal State Budgetary Institution N.N. Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russian Federation

Research Funding

No funding received
None

Background: patients with triple negative breast cancer has poor survival outcomes. Achievement of pathological complete response (pCR) after neoadjuvant chemotherapy can significantly improve survival of these patients, however some patients will relapse even after pCR. Methods: we reviewed prospectively-maintained outcomes database of N.N. Blokhin NMRCO. We extracted information about patients with locally advanced non-metastatic (stage IIIA-IIIC) triple negative breast cancer who were treated with neoadjuvant platinum based chemotherapy in 2014-2018 years. All included patients were tested for the presence of BRCA1/2 mutation with whole-exome next-generation sequencing or for “founder” hot-spot mutations. Results: we identified 80 patients who received neoadjuvant treatment with various platinum-based regimens. Pathological complete response rate was 62.5%. BRCA-mutations was found at 22 (27.5%) patients. Median follow-up time was 35.6 months (17.0 – 61.3). 2-year DFS was 77.3%, and 3-year DFS was 70.0%, there was significant differences in DFS in patients, who achieved and patients with residual tumor – 85,2% vs 64,3% (p=0,028). 2-year OS was 91%, 3-year OS was 78,5%. 18 patient had disease progression, the most common sites of disease progression were brain (9 [50.0%]), lungs (5 [27.8%]), 3 (16.7%) patients had locoregional relapses and 1 (5,6%) liver metastases. We separately analysed characteristics of patients with brain metastases (table). There were no significant differences in tumour pathologic response and patient age. All patients, who relapced after pCR, had brain metastases. We also found, that 7 of 9 patients with brain metastases had different BRCA mutations. Brain metastases developed in 40,9% (9/22) of patients with BRCA1 mutations and 3,4% (2/58) of patients with wild type BRCA1 (p<0,00001). Conclusions:BRCA1 mutation is significant prognostic factor for brain metastases development in locally advanced triple negative breast cancer.

Patient, agepCR/no pCRBRCA1DFS, months
1; 25 y.o.pCRwtBRCA28,1
2, 56 y.o.no pCRwtBRCA13,9
3, 35 y.o.pCRmutBRCA15,83
4, 40 y.o.no pCRmutBRCA9,9
5, 47 y.o.pCRmutBRCA25,23
6, 30 y.o.no pCRmutBRCA16,17
7, 46 y.o.no pCRmutBRCA15,47
8, 38 y.o.no pCRmutBRCA20,8
9, 35 y.o.pCRmutBRCA10,0

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Breast Cancer—Metastatic

Track

Breast Cancer

Sub Track

Triple-Negative

Citation

J Clin Oncol 38: 2020 (suppl; abstr 1079)

DOI

10.1200/JCO.2020.38.15_suppl.1079

Abstract #

1079

Poster Bd #

164

Abstract Disclosures

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