Natural History Of Patients With Brca Mutated High Grade Epithelial Ovarian Cancer Hgeoc Before The Era Of Parp Inhibitors Maintenance In 1st Line Treatment

Background : Maintenance therapy with olaparib considerably improved progression-free survival (PFS) among women with newly-diagnosed, advanced BRCA-mutated high grade epithelial ovarian carcinoma (HGEOC)(1). Based on the large real-life ESME ovarian cancer cohort, we aimed to describe the patient's characteristics and survival outcomes of a selected cohort of BRCA-mutated patients before the era of PARP inhibitors maintenance in first line.Methods : ESME ovarian cancer is a national cohort including all patients with ovarian carcinoma managed in the 18 French Comprehensive Cancer Centres (NCT03275298). ESME Research program collected retrospective data from patient's medical records. BRCA1, BRCA2, or both mutated patients with de novo diagnosed advanced (FIGO stage III or IV) HGEOC were eligible. All data for surgical and medical management were reviewed by medical oncologist or gynecologist oncologist in each centers. PFS was defined as the time from beginning of first line until earliest documented disease progression or death.Results : Of the 4777 patients with ovarian cancer treated in 1st line by platinum-based chemotherapy between 2011 and 2016, 266 patients were included. Median age was 57.0 years (33-81). 187 patients (70.3%) harbored a BRCA1 mutation, and 75 (28.2%) a BRCA2 mutation. Majority of patients (66.9%) had FIGO stage III disease. Almost all patients (95.5%) underwent surgical resection, after neoadjuvant chemotherapy (50%), or upfront debulking surgery (50%). 147 patients (55.3%) received maintenance therapy, majority with bevacizumab alone (78.9%). Some patients, included in clinical trials, received PARP inhibitor alone or in combination with bevacizumab. After a median follow-up of 51.7 months, the median PFS was 28.6 months [95 CI: 26.2-32.4]. A better mPFS was observed for patients with FIGO stage III than stage IV (32.4 months and 25.4 months, respectively), or BRCA2 mutation than BRCA1 (33.3 months and 27.7 months, respectively). Estimated 5-year overall survival (OS) for the whole population was 69.2% [95 CI: 65.3-73.0].Conclusion : This large ESME ovarian cancer cohort described clinical features and real-life survival outcomes among patients with newly diagnosed advanced BRCA-mutated HGEOC treated in comprehensive cancer centres. Looking to the poor prognosis of these patients, before PARPi area, already 55% of patients received maintenance therapy with bevacizumab.

Extensive and up-to-date resource on the full range of gynaecological cancers; practically-focused and essential for the MRCOG examination.

Topics include epidemiology, screening and prevention, pathology, imaging, surgery, radiotherapy, systemic therapies, palliative care, ovarian cancer, endometrial cancer, cervical and vaginal cancer, vulvar cancer, gynaecological sarcomas, gestational trophoblastic disease, ovarian germ cell tumours and decision making in ovarian cancer.

Advances in molecular biology over the last several decades are being steadily applied to our understanding of the molecular biology of cancer, and these advances in knowledge are being translated into the clinical practice of oncology. This volume explores some of the most exciting recent advances in basic research on the molecular biology of cancer and how this knowledge is leading to advances in the diagnosis, treatment, and prevention of cancer. This series provides a forum for discussion of new discoveries, approaches, and ideas Contributions from leading scholars and industry experts Reference guide for researchers involved in molecular biology and related fields