Chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early breast cancer
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Evidence to guide (neo)adjuvant chemotherapy choices in carriers of germline BRCA1/BRCA2 pathogenic variants (BRCA carriers) with early breast cancer (BC) is limited. We evaluated the association of different chemotherapy regimens with survival outcomes in this population. METHODS: The BRCA BCY Collaboration (NCT03673306) is an international, multicenter, retrospective cohort study of BRCA carriers diagnosed with stage I-III BC at age ≤ 40 years, between 2000 and 2020. Disease-free survival (DFS) and overall survival (OS) were assessed among patients with HER2-negative disease treated with anthracycline-taxane, anthracycline-no-taxane, or non-anthracycline (neo)adjuvant chemotherapy. The association of platinum use with outcomes was evaluated in triple-negative breast cancer (TNBC). RESULTS: Among 4200 young BRCA carriers from 109 centres who received (neo)adjuvant chemotherapy for HER2-negative BC, 58.7% had TNBC. Median follow-up was 8.1 years (IQR, 4.7-12.6 years). Anthracycline-taxane, anthracycline-no-taxane, and non-anthracycline regimens were used in 74.4%, 19.3%, and 6.3% of patients, respectively. Platinum agents were administered in 19.8% of TNBC cases. After multivariable adjustment, no significant differences in DFS or OS were observed between anthracycline-no-taxane and anthracycline-taxane regimens (DFS adjusted hazard ratio [aHR] 0.88, 95% CI 0.73-1.05; OS aHR 1.20, 95% CI 0.87-1.67) or non-anthracycline regimens (DFS aHR 1.07, 95% CI 0.82-1.38; OS aHR 1.16, 95% CI 0.68-2.0). In TNBC, platinum use was not associated with improved outcomes. CONCLUSIONS: In young BRCA carriers with HER2-negative early BC, no statistically significant differences in survival outcomes were detected across different chemotherapy regimens. Our findings may inform future prospective studies evaluating chemotherapy de-escalation strategies in this genetically defined population.
Source: European Journal of Cancer
Authors: Rinat Bernstein-Molho, Tal Sella, Virginia Delucchi, Florence Coussy, Hee Jeong Kim, Sabine Linn, Antonio Di Meglio, Katarzyna Pogoda, Ava Kwong, Elisa Agostinetto, Jyoti Bajpai, Yannick Van Herck, Alberta Ferrari, Judith Balmana, Halle C.F. Moore, Fedro A. Peccatori, Ann H. Partridge, Melina Winocur, Tiphaine Renaud, Christine Rousset-Jablonski, Jeong Eon Lee, Angela Toss, Shani Paluch-Shimon, Stephanie M. Wong, Alexios Matikas, Cynthia Villarreal-Garza, Claudio Vernieri, Minna Lee, Deniz Can Guven, Wanda Cui, Kathryn J. Ruddy, Maria Vittoria Dieci, Robert Fruscio, Laura De Marchis, Zoe Kemp, Pedro A. Meireles, Maria Grazia Razeti, Maria Del Pilar Diz, Shelley E. Hwang, Fabio Puglisi, Florian Clatot, Rinat Yerushalmi, Natalia Cichowska-Cwalinska, Alessandra Chirco, Carmine De Angelis, Eva Blondeaux, Matteo Lambertini
Institutions: Tel Aviv University, Sheba Medical Center, Ospedale Policlinico San Martino, IRCCS Azienda Ospedaliera Metropolitana, Institut Curie, Asan Medical Center, University of Ulsan, The Netherlands Cancer Institute, Inserm, Université de Versailles Saint-Quentin-en-Yvelines, Université Paris-Saclay, Centre de recherche en Epidémiologie et Santé des Populations, The Maria Sklodowska-Curie National Research Institute of Oncology, Tung Wah Hospital, Hong Kong Sanatorium and Hospital, University of Hong Kong - Shenzhen Hospital, Université Libre de Bruxelles, Institut Jules Bordet, Homi Bhabha National Institute, Tata Memorial Hospital, KU Leuven, Policlinico San Matteo Fondazione, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institute of Oncology, Cleveland Clinic, European Institute of Oncology, Dana-Farber Cancer Institute, Institut Bergonié, Centre Léon Bérard, Samsung Medical Center, Sungkyunkwan University, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Hebrew University of Jerusalem, Hadassah Medical Center, Jewish General Hospital, McGill University, Karolinska University Hospital, Karolinska Institutet, Hospital Zambrano Hellion, Tecnológico de Monterrey, University of Milan, Fondazione IRCCS Istituto Nazionale dei Tumori, Memorial Sloan Kettering Cancer Center, Hacettepe University, The University of Melbourne, Peter MacCallum Cancer Centre, Mayo Clinic, Mayo Clinic Comprehensive Cancer Center (Minnesota), University of Padua, Istituto Oncologico Veneto, University of Milano-Bicocca, Sapienza University of Rome, Royal Marsden NHS Foundation Trust, Royal Marsden Hospital, Instituto Português de Oncologia Francisco Gentil, Instituto do Câncer do Estado de São Paulo, Duke University, University of Udine, Centro di Riferimento Oncologico, Centre Henri Becquerel, Rabin Medical Center, University Clinical Centre, Gdańsk Medical University, Ospedale Papa Giovanni XXIII, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Scuola Superiore Meridionale, Ente Ospedaliero Ospedali Galliera, University of Genoa
Language: English
Subfield: Genetics
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,270
Funders: Fondazione AIRC per la ricerca sul cancro ETS, Breast Cancer Research Foundation, National Breast Cancer Foundation, Cancer Australia, Korea Health Industry Development Institute, Associazione Italiana per la Ricerca sul Cancro, European Society for Medical Oncology, National Institutes of Health, Medical Research Council, National Health and Medical Research Council, National Cancer Institute
Awards: How can the risk of breast cancer be reduced in those with a strong family history of the disease?, G1690658259, G1730241461, G191863333, G2826672938, Clinical Outcomes In Individuals With An Inherited Predisposition To Breast Cancer, G3507359523, G3696798138, G4151325716, G5121368796, G5330414201, G5729657695, Genes, environment and breast cancer risk: The 15 year follow-up of the Prof-SC, kConFab Clinical Follow-Up Project, G868862665
OpenAlex ID: W7168265486