After neoadjuvant systemic chemotherapy, more BRCA1 carriers achieve a pathologic complete response (pCR) than BRCA2 carriers and than noncarriers, according to a study published online in the Journal of Clinical Oncology (ArunB, et al. September 6, 2011). In addition, the association between gene mutation status and pCR remained, regardless of baseline clinical and tumoral predictive factors or choice of chemotherapy. No statistical difference was found in overall survival rates, however. In this study of 317 women with breast cancer identified through a prospectively maintained single-institution database, researchers searched for significant factors predictive of a pCR as well as evaluated the association between BRCA status and pCR, after adjusting for age, tumor stage, estrogen-receptor (ER) status, nuclear grade, and inclusion of trastuzumab in the chemotherapy regimen.
Data analysis found BRCA1 mutation status, ER negativity, and concurrent trastuzu - mab use to be independent, significant predictors of a pCR. In addition, BRCA1 carriers who achieved a pCR had longer recurrence-free and overall survival at 5 years.