1.First evidence of olaparib maintenance therapy in patients with newly diagnosed homologous recombination deficient positive/BRCA wild-type ovarian cancer: real-world multicenter study.
Jing LI ; Youguo CHEN ; Mian HE ; Xiaoxiang CHEN ; Hao WEN ; Yu KANG ; Kaijiang LIU ; Ge LOU ; Xipeng WANG ; Qinglian WEN ; Li WANG ; Zhongqiu LIN
Frontiers of Medicine 2024;18(6):1026-1034
Although olaparib has demonstrated substantial clinical benefits as maintenance therapy in BRCA mutation-carrying women with newly diagnosed advanced ovarian cancer, its effectiveness in patients without BRCA mutations remains poorly investigated. This study aims to provide the first evidence on the efficacy of mono-olaparib maintenance therapy in such context. Using real-world data from 11 high-volume tertiary care centers in China, a retrospective cohort study was conducted to assess the efficacy and safety of olaparib as first-line maintenance therapy in patients with BRCA wild-type ovarian cancer. The primary objective was 1-year progression-free survival rate. Safety was also evaluated. Fifty patients with a median age of 54 years were included, and all of them tested negative for BRCA mutations but positive for homologous recombination deficiency (HRD). The 1-year PFS rate was 75.2% (95% CI, 63.4 to 89.2), and the median PFS was 21.0 months (95% CI, 13.8 to 28.2). All the patients received olaparib at a starting dose of 300 mg twice daily, and none experienced serious adverse events (AEs). Eight (16%) patients had dose adjustment, but none discontinued olaparib treatment due to AEs. We provide the first evidence that mono-olaparib could be a safe and effective maintenance treatment option for patients newly diagnosed with HRD-positive/BRCA wild-type ovarian cancer.
Humans
;
Female
;
Phthalazines/adverse effects*
;
Piperazines/administration & dosage*
;
Middle Aged
;
Ovarian Neoplasms/genetics*
;
Retrospective Studies
;
Adult
;
Aged
;
Poly(ADP-ribose) Polymerase Inhibitors/administration & dosage*
;
China
;
Maintenance Chemotherapy
;
BRCA2 Protein/genetics*
;
Antineoplastic Agents/adverse effects*
;
Progression-Free Survival
;
BRCA1 Protein/genetics*
3.Identification of a novel germline BRCA2 variant in a male with breast cancer.
Chinese Journal of Medical Genetics 2022;39(3):330-333
OBJECTIVE:
To explore the genetic basis for a male with breast cancer and a sister who had deceased of the disease.
METHODS:
Medical and family history of the proband was collected. Next-generation sequencing was carried out to detect potential variant associated with breast cancer, and Sanger sequencing was used to verify the result.
RESULTS:
The proband was found to harbor a novel heterozygous c.6018dupT variant of the BRCA2 gene which may cause premature termination of mRNA translation, resulting in a truncated protein. Combined with the family history, the variant was deduced to be a germline mutation. Based on the American College of Medical Genetics and Genomics standards and guidelines, c.6018dupT variant of BRCA2 gene was predicted to be pathogenic (PVS1+PM1/2+PP4).
CONCLUSION
The germline variant of the BRCA2 gene probably underlay the breast cancer in this pedigree.
BRCA2 Protein/genetics*
;
Breast Neoplasms, Male/genetics*
;
Genes, BRCA2
;
Genomics
;
Germ Cells
;
Germ-Line Mutation
;
Humans
;
Male
5.Application of next-generation sequencing in detection of BRCA1/2 and homologous recombination repair pathway multi-genes germline mutation and correlation analysis.
Yan Li CHEN ; Zhong Ling ZHUO ; Chang LIU ; Fei XIE ; Zi Yao YANG ; Peng Fei LIU ; Shu WANG ; Xiao Tao ZHAO
Chinese Journal of Preventive Medicine 2022;56(3):302-311
Objective: To investigate the germline mutation status of related genes in breast cancer patients and high-risk individuals by next-generation sequencing. To analyze the correlations between homologous recombination repair (HR) pathway gene mutation status and clinicopathological characteristics of breast cancer patients. To supplement the database of breast cancer related gene mutations in Chinese population. Methods: This study is a cross-sectional study. From October 2020 to September 2021, whole blood samples were collected from 350 breast cancer patients and 49 high-risk individuals, admitted to Peking University People's Hospital and accepted genetic testing voluntarily. Germline mutations in 32 breast cancer related genes were detected by NGS. The clinicopathological characteristics, including age at the onset, family history, unilateral/bilateral tumor, Luminal typing (Luminal A subtype, Luminal B subtype, HER2-enriched subtype and triple negative breast cancer), tumor size and metastasis, were analyzed, and the correlations between HR pathway gene mutation status and clinicopathological characteristics were analyzed by Chi-squared test and Fisher's exact probability test. Results: Among 350 breast cancer patients, 64 (18.3%) cases carried gene pathogenic mutations (including pathogenic and likely pathogenic mutations), including 47 (13.4%) in BRCA1/2, 16 (4.6%) in non-BRCA1/2 genes, 1 (0.3%) in BRCA2 and FANCL. Among 49 high-risk individuals, 7 (14.3%) cases carried gene pathogenic mutations, including 6 (12.3%) in BRCA1/2 and 1 (2%) in ATM genes. BRCA1/2 pathogenic mutations were associated with age at the onset (18%, 8.7%, χ²=6.346, P=0.012), and the BRCA1/2 pathogenic mutation frequency was higher in patients diagnosed at age ≤45 years. HR pathway gene mutations (including pathogenic, likely pathogenic and uncertain significance mutations) were correlated with unilateral/bilateral tumor (49.5%, 68.4%, χ²=4.841, P=0.028) and Luminal typing (45.7%, 62.2%, 32%, 60%, χ²=12.004, P=0.007), and the HR mutation frequencies were higher in patients with bilateral tumor, Luminal B breast cancer and triple negative breast cancer (TNBC). Conclusion: The BRCA1/2 pathogenic mutation frequency in high-risk individuals is similar to that in breast cancer patients, and BRCA1/2 testing is helpful to guide breast cancer screening and prevention in high-risk individuals. Patients with early onset breast cancer, bilateral breast cancer, Luminal B breast cancer and TNBC have higher mutation frequencies of HR pathway genes, and HR pathway genes testing should be conducted as soon as possible to provide laboratory evidence for diagnosis, treatment, prognosis and risk evaluation of breast cancer.
BRCA1 Protein/genetics*
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BRCA2 Protein/genetics*
;
Breast Neoplasms/pathology*
;
Cross-Sectional Studies
;
Female
;
Genetic Predisposition to Disease
;
Germ-Line Mutation
;
High-Throughput Nucleotide Sequencing
;
Humans
;
Middle Aged
;
Mutation
;
Recombinational DNA Repair
;
Triple Negative Breast Neoplasms/pathology*
6.Knowledge and willingness of breast cancer patients from Shanghai for genetic counseling and gene testing.
Xiaolin CHENG ; Zhengdong LI ; Xiaoyin SUN ; Beiqi JIANG ; Zhigang ZHUANG
Chinese Journal of Medical Genetics 2016;33(5):589-593
OBJECTIVETo investigate the knowledge and willingness of breast cancers patients from Shanghai for genetic counseling and gene testing.
METHODSA total of 428 patients filled out the questionnaire and the data was statistically analyzed.
RESULTSMost of the patients were unaware of genetic counseling and gene testing. But after a brief introduction, a majority of them were willing to accept genetic counseling and recommend their family members to participate. The willingness was education- and age-related. When told that gene testing may benefit themselves, 92.1% of the patients were willing to be tested. However, when told that gene testing may only benefit their family, only 33.9% of the patients were willing to join the testing. The acceptance was also age-, education- and family income-related. The difference was statistically significant. Moreover, the willingness ratio to participate the gene testing was lower than expected. Overall, 74.1% of the patients were willing to accept cheaper preliminary gene screening, whilst only 19.2% were willing to accept genetic testing of higher price. Despite of being told that testing results will be maintained as confidential, still 43.2% worried about adverse effects. Such patients tended to younger, from low-income families, with a family history of associated cancers, or personal history of other cancers. The difference was statistically significant.
CONCLUSIONThe majorities of patients do not know but are willing to accept genetic counseling and gene testing and recommend their family to participate. Lack of genetic knowledge, cost for the testing and concerns about discrimination are the obstacles for patients to participate in genetic counseling and gene testing. To spread the knowledge about breast cancer and establish a follow-up screening system for high-risk population may improve the tertiary prevention for breast cancer.
Adult ; Aged ; Asian Continental Ancestry Group ; genetics ; statistics & numerical data ; BRCA1 Protein ; genetics ; BRCA2 Protein ; genetics ; Breast Neoplasms ; diagnosis ; ethnology ; genetics ; Chi-Square Distribution ; China ; Educational Status ; Female ; Genetic Counseling ; Genetic Predisposition to Disease ; genetics ; Genetic Testing ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Social Class
8.Effect of BRCA2 mutation on familial breast cancer survival: A systematic review and meta-analysis.
Jun SHAO ; Jie YANG ; Jun-nai WANG ; Long QIAO ; Wei FAN ; Qing-lei GAO ; Yao-jun FENG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2015;35(5):629-634
Reports of BRCA2 genetic mutations on the prognosis of familial breast cancer (BC) patients have been contradictory. True difference in survival, if it exists, would have important implications for genetic counseling and in treatment of hereditary BC. The purpose of this study was to compare overall survival rate (OSR) among BRCA2 mutation carriers, non-carriers and sporadic BC patients. We searched the PUBMED and EMBASE databases and retrieved 4529 articles using keywords that included breast cancer, BRCA, prognosis and survival. Nine articles were selected for systematic review and among them 6 were included in our meta-analysis. We used the fixed and random effect models to calculate the summary odds ratio (OR) and corresponding 95% confidence interval (CI). BRCA2 mutation carriers had significantly higher long-term OSR than non-carriers (OR=0.69 [95% CI=0.5-0.95]), while both short-term and long-term OSR of BRCA2 mutation carriers did not differ from those of patients with sporadic disease (OR=1.11 [95% CI=0.74-1.65]; 0.85 [95% CI=0.38-1.94], respectively). For BC-specific survival rate (BCSSR), BRCA2 mutation carriers had a similar BCSSR to the non-carriers (OR=0.61 [95% CI=0.28-1.34]). There was no significant difference in disease-free survival (DFS) between BRCA2 mutation carriers and patients with sporadic disease. Our results suggest that BRCA2 mutation increases long-term OSR in hereditary BC, which reminds us a new prospect of management of the disease.
BRCA2 Protein
;
genetics
;
Breast Neoplasms
;
genetics
;
mortality
;
pathology
;
Female
;
Gene Expression
;
Genetic Counseling
;
Genetic Predisposition to Disease
;
Humans
;
Mutation
;
Odds Ratio
;
Prognosis
;
Survival Analysis
9.Effect of PARP1 inhibitor PJ34 on multi-drug resistance in human multiple myeloma cell line and its relationship with FA/BRCA pathway.
Ting XIONG ; Heng WEI ; Xiaoqiong CHEN ; Hui XIAO
Chinese Journal of Medical Genetics 2014;31(3):312-316
OBJECTIVETo investigate the effect of PARP1 inhibitor PJ34 on multi-drug resistance in a human multiple myeloma cell line and its connection with FA/BRCA pathway in DNA damage repair.
METHODSA CCK8 assay was used to measure the inhibition rate. Real-time quantitative PCR was used to detect expression changes of DNA repair genes involved in the FA/BRCA pathway. Western blotting assay was used to detect expression of key protein FANCD2 in the FA/BRCA pathway. Annexin VFITC/PI double staining flow cytometry was used to measure cell apoptosis induced by PJ34. A COMET assay was used to detect the effect of PJ34 on DNA damage repair.
RESULTSPJ34 could significantly enhance the sensitivity of RPMI8226/R cells to melphalan. The IC50 value of melphalan was dropped from 20.43 mol/L to 7.8 mol/L. PJ34 could inhibit the DNA damage repair, and the effect was related with the inhibition of FA/BRCA pathway. PJ34 and melphalan showed a synergistic effect in promoting the apoptosis of RPMI8226/R cells.
CONCLUSIONPJ34 can reverse the resistance of RPMI8226/R cells to melphalan by inhibiting the FA/BRCA pathway, which in turn can induce suppression of DNA damage repair. Therefore, PJ34 may have clinical value in overcoming the multi-drug resistance of multiple myeloma.
Antineoplastic Agents ; pharmacology ; BRCA2 Protein ; genetics ; metabolism ; Cell Line, Tumor ; Drug Resistance, Neoplasm ; Fanconi Anemia Complementation Group D2 Protein ; genetics ; metabolism ; Humans ; Multiple Myeloma ; drug therapy ; enzymology ; genetics ; metabolism ; Phenanthrenes ; pharmacology ; Poly (ADP-Ribose) Polymerase-1 ; Poly(ADP-ribose) Polymerase Inhibitors ; Poly(ADP-ribose) Polymerases ; genetics ; metabolism
10.Pathologic features of BRCA-associated ovarian carcinoma.
Chinese Journal of Pathology 2013;42(12):846-850
Age of Onset
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Cystadenocarcinoma, Serous
;
genetics
;
metabolism
;
pathology
;
Female
;
Genes, BRCA1
;
Genes, BRCA2
;
Humans
;
Immunohistochemistry
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Neoplasm Staging
;
Ovarian Neoplasms
;
genetics
;
metabolism
;
pathology
;
Receptors, Progesterone
;
metabolism
;
Tumor Suppressor Protein p53
;
metabolism

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