BRCA+ mBCa: TNBC tied to poorer survival than HR+/HER2− disease

  • Quek RGW & al.
  • Adv Ther
  • 17 Jan 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Among patients with germline BRCA+ metastatic breast cancer (mBCa), OS is worse for triple-negative breast cancer (TNBC) than hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative mBCa (hereinafter referred to as the TNBC and the HR+ groups, respectively).
  • Testing for germline BRCA was low (16.7%) among the larger cohort of mBCa patients from which the TNBC and HR+ groups were drawn.

Why this matters

  • Patients should be informed of prognosis to make informed decisions about care.
  • Improved testing for germline BRCA mutations is needed, given the availability of new second-line mBCa treatments, olaparib and talazoparib (approved after this study was performed).

Study design

  • Real-world retrospective cohort of 12,021 mBCa patients in the Flatiron Health electronic health record database (2011-2018); 1.9% had germline BRCA mutations (HR+ group, n=165; TNBC group, n=64).
  • Funding: Pfizer Inc.

Key results

  • Only 16.7% of patients were tested for BRCA mutations; 11.4% of these tested positive. 
  • Median OS in the TNBC group was 23.4 (95% CI, 14.9-34.5) months vs 38.0 (95% CI, 30.8-42.9) months in the HR+ group.
  • The HR+ group had 55% better OS (HR, 0.45; P=.002).
  • Most common first-line treatment post-mBCa diagnosis was letrozole (8%) for the HR+ group and capecitabine (14%) for the TNBC group.

Limitations

  • Observational design.

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