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Background <p>Human epidermal growth factor receptor 2 (HER2)-negative operable breast cancer (BC) patients with germline <i>BRCA1/2</i> pathogenic variants may benefit from adjuvant olaparib treatment. However, data about how many patients were eligible for olaparib treatment in operable BC patients with <i>BRCA1/2</i> variants after neoadjuvant chemotherapy (NACT) is lacking.</p> Methods <p>A total of 341 operable BC with germline <i>BRCA1/2</i> pathogenic variants who received NACT at our institute between October 2003 and May 2015 were included. Pathological complete response (pCR) and survival were estimated.</p> Results <p>Of the 341 <i>BRCA1/2</i> carriers (<i>BRCA1</i>:&#xa0;139; <i>BRCA2:</i> 202), 295 (88.1%) cases exhibited HER2-negative BC in the entire cohort. The most common subtype was triple-negative (TN) BC (62.0%) for <i>BRCA1</i> carriers and hormone receptor (HR)-positive/HER2-negative BC (68.2%) for <i>BRCA2</i> carriers, respectively. The pCR rate were 39.6% for <i>BRCA1</i> carriers and 28.2% for <i>BRCA2</i> carries. The pCR rate in TNBC, HR-positive/HER2-negative BC, and HER2-positive BC were 45.0%, 22.3%, and 45.0% in the entire cohort, respectively. Of these HR-positive/HER2-negative BC patients, 16.0% had non-pCR and exhibited CPS+EG≥3. Overall, 31.9% of the HER2-negative BC cohort were potential candidates for adjuvant olaparib, with 44.0% for <i>BRCA1</i> carriers and 22.9% for <i>BRCA2</i> carriers. Furthermore, patients with non-pCR exhibited a worse survival regardless of TNBC and HR-positive/HER2-negative BC disease, especially for HR-positive/HER2-negative BC with CPS+EG≥3.</p> Conclusion <p>Approximately one-third of HER2-negative BC patients with <i>BRCA1/2</i> pathogenic variants are potential candidates for adjuvant olaparib treatment after NACT, with a higher proportion for <i>BRCA1</i> carriers compared to <i>BRCA2</i> carriers.</p>

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Potential candidates for adjuvant olaparib treatment in operable breast cancer patients with germline BRCA1/2 pathogenic variants after neoadjuvant chemotherapy

  • 期刊论文

  • 发表日期：

    2025年3月19日

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  • Huimin Liu,
  • Furong Kou,
  • Li Hu,
  • Jie Sun,
  • Juan Zhang,
  • Ye Xu,
  • Lu Yao,
  • Yuntao Xie

摘要

Background

Human epidermal growth factor receptor 2 (HER2)-negative operable breast cancer (BC) patients with germline BRCA1/2 pathogenic variants may benefit from adjuvant olaparib treatment. However, data about how many patients were eligible for olaparib treatment in operable BC patients with BRCA1/2 variants after neoadjuvant chemotherapy (NACT) is lacking.

Methods

A total of 341 operable BC with germline BRCA1/2 pathogenic variants who received NACT at our institute between October 2003 and May 2015 were included. Pathological complete response (pCR) and survival were estimated.

Results

Of the 341 BRCA1/2 carriers (BRCA1: 139; BRCA2: 202), 295 (88.1%) cases exhibited HER2-negative BC in the entire cohort. The most common subtype was triple-negative (TN) BC (62.0%) for BRCA1 carriers and hormone receptor (HR)-positive/HER2-negative BC (68.2%) for BRCA2 carriers, respectively. The pCR rate were 39.6% for BRCA1 carriers and 28.2% for BRCA2 carries. The pCR rate in TNBC, HR-positive/HER2-negative BC, and HER2-positive BC were 45.0%, 22.3%, and 45.0% in the entire cohort, respectively. Of these HR-positive/HER2-negative BC patients, 16.0% had non-pCR and exhibited CPS+EG≥3. Overall, 31.9% of the HER2-negative BC cohort were potential candidates for adjuvant olaparib, with 44.0% for BRCA1 carriers and 22.9% for BRCA2 carriers. Furthermore, patients with non-pCR exhibited a worse survival regardless of TNBC and HR-positive/HER2-negative BC disease, especially for HR-positive/HER2-negative BC with CPS+EG≥3.

Conclusion

Approximately one-third of HER2-negative BC patients with BRCA1/2 pathogenic variants are potential candidates for adjuvant olaparib treatment after NACT, with a higher proportion for BRCA1 carriers compared to BRCA2 carriers.