Improved survival in non-Ashkenazi Jewish ovarian cancer patients with BRCA1 and BRCA2 gene mutations

Robin A. Lacour, Shannon N. Westin, Larissa A. Meyer, Shana N. Wingo, John O. Schorge, Rebecca Brooks, David Mutch, Ashley Molina, Rebecca Sutphen, MacK Barnes, Jeffrey Elder, Deanna Teoh, C. Bethan Powell, Veena Choubey, Stephanie Blank, Heather R. MacDonald, Mark F. Brady, Diana L. Urbauer, Diane Bodurka, David M. GershensonKaren H. Lu

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Objectives: Previous studies report a survival advantage in ovarian cancer patients with Ashkenazi Jewish (AJ) breast cancer gene (BRCA) founder mutations. The purpose of this study was to determine if this association exists in patients with non-Ashkenazi Jewish (non-AJ) BRCA mutations. We also sought to account for "survival bias" by minimizing lead time that may exist between diagnosis and genetic testing. Methods: Patients with stage III/IV ovarian cancer and a non-AJ BRCA mutation, seen between January 1996 and July 2007, were identified from eight institutions. Patients with sporadic ovarian cancer were compared to similar cases, matched by age, stage, year of diagnosis, and vital status at time interval to BRCA testing. Progression-free (PFS) and overall survival (OS) were calculated by the Kaplan-Meier method. Multivariate Cox proportional hazards models were calculated for variables of interest. Fisher's exact test and chi-square were also used for analysis. Results: Ninety-five advanced stage ovarian cancer patients with non-AJ BRCA mutations and 183 sporadic controls were analyzed. Compared to sporadic ovarian cancer patients, non-AJ BRCA patients had longer PFS (27.9 months vs. 17.9 months, HR 0.61 [95% CI 0.43-0.86]) and OS (101.7 months vs. 54.3 months, HR 0.43 [95% CI 0.27-0.68]). BRCA status was an independent predictor of PFS and OS. Conclusions: This multicenter study demonstrates a significant survival advantage in advanced stage ovarian cancer patients with non-AJ BRCA mutations, confirming the previous studies in the Jewish population. This improved survival was evident when accounting for the "survival bias" that coincides with genetic testing.

Original languageEnglish (US)
Pages (from-to)358-363
Number of pages6
JournalGynecologic Oncology
Volume121
Issue number2
DOIs
StatePublished - May 1 2011
Externally publishedYes

Keywords

  • BRCA
  • Non-Askenazi Jewish
  • Ovarian cancer
  • Survival
  • Survival bias

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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