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Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama

Received: 24 October 2022    Accepted: 7 November 2022    Published: 16 November 2022
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Abstract

Introduction: Epithelial ovarian cancer includes high-grade serous histology (HGSOC), which represents 90% of patients and at the time of diagnosis and presents in an advanced stage in 75% of patients. The BRCA1/2 mutation is present in 10-15% of women with this diagnosis. Objective: To describe the clinicopathological characteristics of patients with ovarian cancer with BRCA1/2 mutation and our experience in terms of objective response and survival with the use of olaparib. Methodology: We performed a retrospective review of the electronic records of patients with advanced-stage BRCA 1/2 mutated ovarian cancer or recurrent disease treated with olaparib. Results: 18 patients presented with a BRCA1/2 mutation from 2018 to May 2022, with a mean age of 60 years, and 100% had high-grade serous carcinoma histology. Germline BRCA1 mutations were found in 11 patients and somatic BRCA2 mutations were identified in patients. Fourteen patients were treated in the second line with olaparib, and four were treated in the first line setting. Fifteen patients achieved a partial response to platinum, and the rest had complete responses. With olaparib, the objective response rate was 30%, with the best response being a partial response in six patients (33.3%). The median PFS was 12 months, and the median OS was 29 months in the second line treatment. Conclusions: The incidence of BRCA mutated ovarian cancer appears to be low in patients at our institution; however patients with BRCA1/2 mutation show favorable outcomes following second-line treatment with olaparib. This finding supports a therapy change for patients with this indication to first line olaparib treatment in our institution.

Published in International Journal of Clinical Oncology and Cancer Research (Volume 7, Issue 4)
DOI 10.11648/j.ijcocr.20220704.12
Page(s) 89-92
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Advanced, Ovarian Cancer, BRCA1 and 2, Somatic Mutation, Germline Mutation, Olaparib, Recurrence

References
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[2] Registro hospitalario de cáncer RHC-ION. Boletín 2020. [RHC-ION Hospital Cancer Registry. Newsletter 2020].
[3] Registro nacional del cáncer de panamá. Boletín estadístico- año 2019. [Panama National Cancer Registry. Statistical bulletin- year 2019].
[4] Cook SA, Tinker A V. PARP inhibitors and the evolving landscape of ovarian cancer management: A Review. BioDrugs [Internet]. 2019; 33 (3): 255–73. Available from: https://doi.org/10.1007/s40259-019-00347-4
[5] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019; 69 (1): 7–34.
[6] Alsop K, Fereday S, Meldrum C, DeFazio A, Emmanuel C, George J, et al. BRCA mutation frequency and patterns of treatment response in BRCA mutation-positive women with ovarian cancer: A report from the Australian ovarian cancer study group. J Clin Oncol. 2012; 30 (21): 2654–63.
[7] Girolimetti G, Perrone AM, Santini D, Barbieri E, Guerra F, Ferrari S, et al. BRCA-associated ovarian cancer: From molecular genetics to risk management. Biomed Res Int. 2014.
[8] Lino-Silva LS. Ovarian carcinoma: Pathology review with an emphasis in their molecular characteristics. Chinese Clin Oncol. 2020; 9 (4): 1–10.
[9] Ozols RF, Bundy BN, Greer BE, Fowler JM, Clarke-Pearson D, Burger RA, et al. Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: A Gynecologic Oncology Group study. J Clin Oncol. 2003; 21 (17): 3194–200.
[10] Kurnit KC, Fleming GF, Lengyel E. Updates and new ptions in advanced epithelial ovarian cancer treatment. Obstet Gynecol. 2021; 137 (1): 108–21.
[11] Tiffany Foo; Ángela George; Susana Banerjee; (2021). Inhibidores de PARP en el cáncer de ovario: una descripción general de los ensayos que cambian la práctica. Genes, Cromosomas y Cáncer. doi: 10.1002/gcc.22935.
[12] Pujade-Lauraine E, Ledermann JA, Selle F, Gebski V, Penson RT, Oza AM, et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2017; 18 (9): 1274–84.
[13] Andres Poveda, et al (2020). Final overall survival (OS) results of SOLO2/ENGOT-ov21: a phase III trial evaluating maintenance olaparib in patients (pts) with recurrent platinum-sensitive ovarian cancer and a BRCA mutation. Journal of Clinical Oncology 2020 38: 15_suppl, 6002-6002.
[14] Moore K, Colombo N, Scambia G, Kim B-G, Oaknin A, Friedlander M, et al. Maintenance olaparib in patients with newly diagnosed advanced ovarian cancer. N Engl J Med. 2018; 379 (26): 2495–505.
[15] LaFargue CJ, Dal Molin GZ, Sood AK, Coleman RL. Exploring and comparing adverse events between PARP inhibitors. Lancet Oncol [Internet]. 2019; 20 (1): e15–28. Available from: http://dx.doi.org/10.1016/S1470-2045(18)30786-1
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    Kayra Sanchez Munoz, Jose Pinto Llerena, Cristiane Martin. (2022). Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama. International Journal of Clinical Oncology and Cancer Research, 7(4), 89-92. https://doi.org/10.11648/j.ijcocr.20220704.12

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    ACS Style

    Kayra Sanchez Munoz; Jose Pinto Llerena; Cristiane Martin. Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama. Int. J. Clin. Oncol. Cancer Res. 2022, 7(4), 89-92. doi: 10.11648/j.ijcocr.20220704.12

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    AMA Style

    Kayra Sanchez Munoz, Jose Pinto Llerena, Cristiane Martin. Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama. Int J Clin Oncol Cancer Res. 2022;7(4):89-92. doi: 10.11648/j.ijcocr.20220704.12

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  • @article{10.11648/j.ijcocr.20220704.12,
      author = {Kayra Sanchez Munoz and Jose Pinto Llerena and Cristiane Martin},
      title = {Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama},
      journal = {International Journal of Clinical Oncology and Cancer Research},
      volume = {7},
      number = {4},
      pages = {89-92},
      doi = {10.11648/j.ijcocr.20220704.12},
      url = {https://doi.org/10.11648/j.ijcocr.20220704.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20220704.12},
      abstract = {Introduction: Epithelial ovarian cancer includes high-grade serous histology (HGSOC), which represents 90% of patients and at the time of diagnosis and presents in an advanced stage in 75% of patients. The BRCA1/2 mutation is present in 10-15% of women with this diagnosis. Objective: To describe the clinicopathological characteristics of patients with ovarian cancer with BRCA1/2 mutation and our experience in terms of objective response and survival with the use of olaparib. Methodology: We performed a retrospective review of the electronic records of patients with advanced-stage BRCA 1/2 mutated ovarian cancer or recurrent disease treated with olaparib. Results: 18 patients presented with a BRCA1/2 mutation from 2018 to May 2022, with a mean age of 60 years, and 100% had high-grade serous carcinoma histology. Germline BRCA1 mutations were found in 11 patients and somatic BRCA2 mutations were identified in patients. Fourteen patients were treated in the second line with olaparib, and four were treated in the first line setting. Fifteen patients achieved a partial response to platinum, and the rest had complete responses. With olaparib, the objective response rate was 30%, with the best response being a partial response in six patients (33.3%). The median PFS was 12 months, and the median OS was 29 months in the second line treatment. Conclusions: The incidence of BRCA mutated ovarian cancer appears to be low in patients at our institution; however patients with BRCA1/2 mutation show favorable outcomes following second-line treatment with olaparib. This finding supports a therapy change for patients with this indication to first line olaparib treatment in our institution.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Experience in the Management of Patients with Advanced or Recurrent BRCA1/2 Mutated Ovarian Cancer with Olaparib at the National Oncology Institute of Panama
    AU  - Kayra Sanchez Munoz
    AU  - Jose Pinto Llerena
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    DO  - 10.11648/j.ijcocr.20220704.12
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    JF  - International Journal of Clinical Oncology and Cancer Research
    JO  - International Journal of Clinical Oncology and Cancer Research
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    UR  - https://doi.org/10.11648/j.ijcocr.20220704.12
    AB  - Introduction: Epithelial ovarian cancer includes high-grade serous histology (HGSOC), which represents 90% of patients and at the time of diagnosis and presents in an advanced stage in 75% of patients. The BRCA1/2 mutation is present in 10-15% of women with this diagnosis. Objective: To describe the clinicopathological characteristics of patients with ovarian cancer with BRCA1/2 mutation and our experience in terms of objective response and survival with the use of olaparib. Methodology: We performed a retrospective review of the electronic records of patients with advanced-stage BRCA 1/2 mutated ovarian cancer or recurrent disease treated with olaparib. Results: 18 patients presented with a BRCA1/2 mutation from 2018 to May 2022, with a mean age of 60 years, and 100% had high-grade serous carcinoma histology. Germline BRCA1 mutations were found in 11 patients and somatic BRCA2 mutations were identified in patients. Fourteen patients were treated in the second line with olaparib, and four were treated in the first line setting. Fifteen patients achieved a partial response to platinum, and the rest had complete responses. With olaparib, the objective response rate was 30%, with the best response being a partial response in six patients (33.3%). The median PFS was 12 months, and the median OS was 29 months in the second line treatment. Conclusions: The incidence of BRCA mutated ovarian cancer appears to be low in patients at our institution; however patients with BRCA1/2 mutation show favorable outcomes following second-line treatment with olaparib. This finding supports a therapy change for patients with this indication to first line olaparib treatment in our institution.
    VL  - 7
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Author Information
  • Medical Oncology Service, National Oncology Institute of Panama, Panama City, Panama

  • Medical Oncology Service, National Oncology Institute of Panama, Panama City, Panama

  • Medical Oncology Service, National Oncology Institute of Panama, Panama City, Panama

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