Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers
Background: Approximately 6% of women with breast cancer carry pathogenic germline variants in predisposition genes such as BRCA1 and BRCA2. Depending on personal and family cancer history, it is therefore recommended to test for hereditary breast cancer. Moreover, as shown by the phase III OlympiA...
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MDPI AG
2023-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/15/3847 |
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| author | Dominik Dannehl Tobias Engler Léa Louise Volmer Christian Martin Tegeler Julia Fusshoeller Emma Gabrysch Kenneth Eissler Anna Seller Eva-Maria Grischke Markus Hahn Ines Gruber Fabienne Schochter Kerstin Pfister Kristina Veselinovic Elena Leinert Brigitte Rack Visnja Fink Wolfgang Janni Sara Yvonne Brucker Andreas Daniel Hartkopf Henning Schäffler |
| author_facet | Dominik Dannehl Tobias Engler Léa Louise Volmer Christian Martin Tegeler Julia Fusshoeller Emma Gabrysch Kenneth Eissler Anna Seller Eva-Maria Grischke Markus Hahn Ines Gruber Fabienne Schochter Kerstin Pfister Kristina Veselinovic Elena Leinert Brigitte Rack Visnja Fink Wolfgang Janni Sara Yvonne Brucker Andreas Daniel Hartkopf Henning Schäffler |
| author_sort | Dominik Dannehl |
| collection | DOAJ |
| description | Background: Approximately 6% of women with breast cancer carry pathogenic germline variants in predisposition genes such as BRCA1 and BRCA2. Depending on personal and family cancer history, it is therefore recommended to test for hereditary breast cancer. Moreover, as shown by the phase III OlympiA trial, olaparib significantly improves overall survival in patients with HER2 negative (HER2−) early breast cancer who (1) carry a BRCA1 or BRCA2 germline mutation (gBRCA1/2-positive), (2) have received (neo)adjuvant chemotherapy and (3) are at high clinical risk. The objective of the current analysis was to determine the number of patients with early HER2− breast cancer who are at high clinical risk, according to the inclusion criteria of OlympiA, and to estimate how many of these patients would meet the criteria for hereditary cancer testing in a real-world analysis. Methods: All patients included in this retrospective analysis were treated for early breast cancer (eBC) at the Department of Gynecology and Obstetrics, Ulm University Hospital, Germany, and the Department of Women’s Health at Tuebingen University Hospital, Germany, between January 2018 and December 2020. Patients were identified as high risk, in line with the clinicopathological determiners used in the OlympiA trial. The criteria of the German Consortium for Hereditary Breast and Ovarian Cancer were used to identify patients who qualify for hereditary cancer testing. Results: Of 2384 eligible patients, 1738 patients (72.9%) showed a hormone receptor positive (HR+)/HER2− tumor biology, 345 patients (14.5%) displayed HER2+ breast cancer and 301 patients (12.6%) suffered from HR-/HER2− breast cancer (TNBC). Of 2039 HER2− breast cancer patients, 271 patients (13.3%) were at high clinical risk. This cohort encompassed 130 of the 1738 patients with HR+/HER2− breast cancer (7.5%) and 141 of 301 patients with TNBC (46.8%). A total of 121 of 271 patients (44.6%) with high clinical risk met the criteria for hereditary cancer testing (34 of 130 (26.2%) HR+/HER2− patients and 87 of 141 (61.7%) patients with TNBC). Conclusion: Approximately one in ten patients with HR+/HER2−, and half of the patients with TNBC, meet the high-risk criteria according to OlympiA. Half of these patients do not meet the criteria for hereditary cancer testing and should therefore be tested for the presence of gBRCA1/2 mutations, irrespective of their own or family cancer history. The overall number of patients with early breast cancer benefiting from olaparib needs to be investigated in future studies. |
| first_indexed | 2024-03-11T00:30:38Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T00:30:38Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-aae071f56e93448b821ea2bdb8e6776c2023-11-18T22:42:13ZengMDPI AGCancers2072-66942023-07-011515384710.3390/cancers15153847Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast CentersDominik Dannehl0Tobias Engler1Léa Louise Volmer2Christian Martin Tegeler3Julia Fusshoeller4Emma Gabrysch5Kenneth Eissler6Anna Seller7Eva-Maria Grischke8Markus Hahn9Ines Gruber10Fabienne Schochter11Kerstin Pfister12Kristina Veselinovic13Elena Leinert14Brigitte Rack15Visnja Fink16Wolfgang Janni17Sara Yvonne Brucker18Andreas Daniel Hartkopf19Henning Schäffler20Department of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Women’s Health, Tuebingen University, 72076 Tuebingen, GermanyDepartment of Gynecology and Obstetrics, University Hospital, 89075 Ulm, GermanyBackground: Approximately 6% of women with breast cancer carry pathogenic germline variants in predisposition genes such as BRCA1 and BRCA2. Depending on personal and family cancer history, it is therefore recommended to test for hereditary breast cancer. Moreover, as shown by the phase III OlympiA trial, olaparib significantly improves overall survival in patients with HER2 negative (HER2−) early breast cancer who (1) carry a BRCA1 or BRCA2 germline mutation (gBRCA1/2-positive), (2) have received (neo)adjuvant chemotherapy and (3) are at high clinical risk. The objective of the current analysis was to determine the number of patients with early HER2− breast cancer who are at high clinical risk, according to the inclusion criteria of OlympiA, and to estimate how many of these patients would meet the criteria for hereditary cancer testing in a real-world analysis. Methods: All patients included in this retrospective analysis were treated for early breast cancer (eBC) at the Department of Gynecology and Obstetrics, Ulm University Hospital, Germany, and the Department of Women’s Health at Tuebingen University Hospital, Germany, between January 2018 and December 2020. Patients were identified as high risk, in line with the clinicopathological determiners used in the OlympiA trial. The criteria of the German Consortium for Hereditary Breast and Ovarian Cancer were used to identify patients who qualify for hereditary cancer testing. Results: Of 2384 eligible patients, 1738 patients (72.9%) showed a hormone receptor positive (HR+)/HER2− tumor biology, 345 patients (14.5%) displayed HER2+ breast cancer and 301 patients (12.6%) suffered from HR-/HER2− breast cancer (TNBC). Of 2039 HER2− breast cancer patients, 271 patients (13.3%) were at high clinical risk. This cohort encompassed 130 of the 1738 patients with HR+/HER2− breast cancer (7.5%) and 141 of 301 patients with TNBC (46.8%). A total of 121 of 271 patients (44.6%) with high clinical risk met the criteria for hereditary cancer testing (34 of 130 (26.2%) HR+/HER2− patients and 87 of 141 (61.7%) patients with TNBC). Conclusion: Approximately one in ten patients with HR+/HER2−, and half of the patients with TNBC, meet the high-risk criteria according to OlympiA. Half of these patients do not meet the criteria for hereditary cancer testing and should therefore be tested for the presence of gBRCA1/2 mutations, irrespective of their own or family cancer history. The overall number of patients with early breast cancer benefiting from olaparib needs to be investigated in future studies.https://www.mdpi.com/2072-6694/15/15/3847breast cancerBRCAolaparib |
| spellingShingle | Dominik Dannehl Tobias Engler Léa Louise Volmer Christian Martin Tegeler Julia Fusshoeller Emma Gabrysch Kenneth Eissler Anna Seller Eva-Maria Grischke Markus Hahn Ines Gruber Fabienne Schochter Kerstin Pfister Kristina Veselinovic Elena Leinert Brigitte Rack Visnja Fink Wolfgang Janni Sara Yvonne Brucker Andreas Daniel Hartkopf Henning Schäffler Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers Cancers breast cancer BRCA olaparib |
| title | Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers |
| title_full | Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers |
| title_fullStr | Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers |
| title_full_unstemmed | Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers |
| title_short | Which Patients Do We Need to Test for BRCA1/2 Mutation? Feasibility of Adjuvant Olaparib Treatment in Early Breast Cancer–Real-World Data from Two Large German Breast Centers |
| title_sort | which patients do we need to test for brca1 2 mutation feasibility of adjuvant olaparib treatment in early breast cancer real world data from two large german breast centers |
| topic | breast cancer BRCA olaparib |
| url | https://www.mdpi.com/2072-6694/15/15/3847 |
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