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Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Monday, May 19, 2025
Based on the results of an analysis published in the European Journal of Cancer, germline and somatic BRCA1/2 mutations appear to be equivalent in their association with prolonged survival in patients with high-grade serous tubo-ovarian carcinoma. Additionally, according to Robert L. Hollis, PhD, of the University of Edinburgh, and colleagues, mutations in non-BRCA homologous recombination repair (HRR) genes may be associated with highly favorable survival outcomes.
The investigators focused on data from two well-characterized cohorts; cohort 1 (n = 174) comprised matched formalin-fixed paraffin-embedded tumor and normal samples with panel-based sequencing, and cohort 2 (n = 279) comprised matched fresh tumor and normal samples with whole-genome sequencing. An external validation was performed using samples from The Cancer Genome Atlas ovarian cancer analysis (n = 316).
Patients with HRR-mutant tumors (ie, BRCA1, BRCA2, non-BRCA HRR-mutant) were found to experience prolonged survival across both cohorts (cohort 1: multivariable hazard ratio [HR] = 0.53; cohort 2: multivariable HR = 0.36). In the combined cohort (1 + 2), compared with HRR wild-type cases, germline (multivariable HR = 0.50) and somatic (multivariable HR = 0.41) BRCA1/2 mutations appeared to confer similar levels of survival advantage. These findings were validated using the external dataset (germline BRCA1/2: multivariable HR = 0.56; somatic BRCA1/2: multivariable HR = 0.48).
Non-BRCA HRR mutations seemed to be associated with a survival advantage (vs HRR wild-type tumors: multivariable HR = 0.22). According to the investigators, the survival advantage in both germline and somatic BRCA1-mutant cases was less marked (vs non-BRCA HRR-mutant tumors: multivariable HR = 0.41). Germline BRCA1/2, somatic BRCA1/2, and non-BRCA HRR mutations were all found to be associated with high scores on a whole-genome sequencing–based classifier of HRR deficiency (vs HRR wild-type tumors: median, 1.00 vs 0.56; P < .01).
Disclosure: For full disclosures of the study authors, visit ejcancer.com.
