“高风险”早期乳腺癌的真实患病率、治疗和生存率，根据 OlympiA 试验纳入标准强制检测 gBRCA1/2 突变：来自基于人群的登记的数据。
Real-world prevalence, treatment and survival of "high risk" early breast cancer, with mandatory testing of gBRCA1/2 mutation according to the OlympiA trial inclusion criteria: Data from a population-based registry.
发表日期：2024 Aug 28
作者：
Sylvain Ladoire, Ariane Mamguem Kamga, Loick Galland, Isabelle Desmoulins, Didier Mayeur, Courèche Kaderbhai, Silvia Mihaelia Ilie, Audrey Hennequin, Clementine Jankowski, Juliette Albuisson, Sophie Nambot, Charles Coutant, Laurent Arnould, Manon Reda, Caroline Truntzer, Sandrine Dabakuyo
来源：
BREAST
摘要：
OlympiA 研究的结果导致 PARP 抑制剂（olaparib）被批准用于具有生殖系 BRCA1/2 突变（gBRCAm）患者的复发高风险早期乳腺癌（eBC）的辅助治疗。然而，在常规实践中符合 OlympiA 研究中应用的“高风险”标准的患者比例以及现在强制进行 gBRCAm 检测的患者比例仍然未知。在这项基于人群的研究中，我们使用来自法国专门的 Côte d'Or 乳腺癌和妇科癌症登记处，旨在评估 2005 年至 2015 年间接受标准治疗的 eBC 患者的实际比例和长期预后，根据 OlympiA，这些患者处于复发“高风险”试验标准。我们纳入了 3483 名接受 HER2 阴性 eBC 治疗的患者（N = 380 名 ER- 患者，N = 3103 名 ER 肿瘤患者）。我们发现 N = 62 (1.8 %) 患者患有 gBRCA1/2 突变。根据奥林匹亚标准，共有 494 名患者（14.2%）被归类为“高风险”； ER 肿瘤为 55%，ER 肿瘤为 9.1%。尽管“高风险”患者接受了更强化的全身治疗，但与其他患者相比，这些“高风险”患者的 10 年总生存率要差得多：ER 肿瘤中为 60.1% vs 83.8%，ER 肿瘤中为 55.4% vs 84.1%肿瘤。我们对净生存率的估计显示出更大的差异。这项研究为高危 eBC 患者的患病率和预后提供了真实的见解，在奥拉帕尼辅助治疗的批准需要仔细重组护理的背景下，以免忽视可以从奥拉帕尼辅助治疗中获益的 gBRCAm 患者。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。
The results of the OlympiA study led to the approval of a PARP inhibitor (olaparib) as adjuvant treatment for early breast cancer (eBC) at high risk of relapse in patients with a germline BRCA1/2 mutation (gBRCAm). However, the proportion of patients in routine practice who meet the "high-risk" criteria applied in the OlympiA study, and for whom gBRCAm testing would now be mandatory, remains unknown.In this population-based study, we use unique data from the French specialized Côte d'Or Breast and Gynecological Cancer Registry, to assess the real-life proportion, and long-term prognosis of patients treated for eBC between 2005 and 2015 with standard treatment, and at "high risk" of relapse according to the OlympiA trial criteria.We included 3483 patients treated for HER2-negative eBC (N = 380 with ER-, and N = 3103 with ER + tumor). We found N = 62 (1.8 %) patients with gBRCA1/2 mutations. A total of 494 patients (14.2 %) were classified as "high risk" according to the Olympia criteria; 55 % with ER-tumors, and 9.1 % with ER + tumors, respectively. Despite more intensive systemic treatments in "high risk" patients, 10-year overall survival was much worse in these "high risk" patients compared to the others: 60.1 % vs 83.8 % in ER-tumors, and 55.4 % vs 84.1 % in ER + tumors. Our estimates of net survival show an even greater difference.This study provides real-life insights into the prevalence and prognosis of patients with high-risk eBC, in a context where the approval of adjuvant olaparib requires careful reorganization of care, so as not to overlook a patient with gBRCAm who could benefit from adjuvant olaparib.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.