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Published in: Breast Cancer Research 4/2012

Open Access 01-08-2012 | Research article

Results of a phase II open-label, non-randomized trial of cisplatin chemotherapy in patients with BRCA1-positive metastatic breast cancer

Authors: Tomasz Byrski, Rebecca Dent, Pawel Blecharz, Malgorzata Foszczynska-Kloda, Jacek Gronwald, Tomasz Huzarski, Cezary Cybulski, Elzbieta Marczyk, Robert Chrzan, Andrea Eisen, Jan Lubinski, Steven A Narod

Published in: Breast Cancer Research | Issue 4/2012

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Abstract

Introduction

The purpose of this investigation was to evaluate the efficacy of cisplatin chemotherapy in BRCA1 mutation carriers with metastatic breast cancer.

Methods

In a phase II, open-label study, 20 patients with metastatic breast cancer who carried a mutation in BRCA1 were treated with cisplatin 75 mg/m2 intravenously every 3 weeks as part of a 21-day cycle for 6 cycles. Restaging studies to assess response were performed after cycles 2 and 6, and every three months thereafter.

Results

Between July 2007 and January 2009, 20 patients were enrolled. Baseline characteristics were as follows: 65% had prior adjuvant chemotherapy, 55% had prior chemotherapy for metastatic breast cancer; mean age was 48 years (ranges 32 to 70); 30% estrogen receptor (ER) or progesterone receptor (PR)+, 70% ER/PR/Human Epidermal Growth Factor Receptor 2 (HER2)- and 0% HER2+. Overall response rate was 80%; nine patients experienced a complete clinical response (45%) and seven experienced a partial response (35%). Overall survival was 80% at one year, 60% at two years and 25% at three years. Four of the 20 patients are alive four years after initiating treatment. The median time to progression was 12 months. The median survival from the start of cisplatinum treatment was 30 months. Cisplatin-related adverse events, including nausea (50%), anemia (5%) and neutropenia (35%) were mostly mild to moderate in severity.

Conclusions

This phase II study demonstrates that cisplatin chemotherapy has high activity in women with a BRCA1 mutation and metastatic breast cancer and is generally well tolerated.

Trial registration

This trial is registered retrospectively on the clinical trials website ClinicalTrials.gov. The identifier is NCT01611727.
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Literature
1.
go back to reference Chappuis PO, Goffin J, Wong N, Perret C, Ghadirian P, Tonin PN, Foulkes WD: A significant response to neo-adjuvant chemotherapy in BRCA1/2 related breast cancer. J Med Genet. 2002, 39: 608-610. 10.1136/jmg.39.8.608.CrossRefPubMedPubMedCentral Chappuis PO, Goffin J, Wong N, Perret C, Ghadirian P, Tonin PN, Foulkes WD: A significant response to neo-adjuvant chemotherapy in BRCA1/2 related breast cancer. J Med Genet. 2002, 39: 608-610. 10.1136/jmg.39.8.608.CrossRefPubMedPubMedCentral
2.
go back to reference Byrski T, Gronwald J, Huzarski T, Grzybowska E, Budryk M, Stawicka M, Mierzwa T, Szwiec M, Wiśniowski R, Siolek M, Narod SA, Lubinski J: Response to neoadjuvant chemotherapy in women with BRCA1-positive breast cancers. Breast Cancer Res Treat. 2008, 108: 289-296. 10.1007/s10549-007-9600-1.CrossRefPubMed Byrski T, Gronwald J, Huzarski T, Grzybowska E, Budryk M, Stawicka M, Mierzwa T, Szwiec M, Wiśniowski R, Siolek M, Narod SA, Lubinski J: Response to neoadjuvant chemotherapy in women with BRCA1-positive breast cancers. Breast Cancer Res Treat. 2008, 108: 289-296. 10.1007/s10549-007-9600-1.CrossRefPubMed
3.
go back to reference Fong PC, Boss DS, Yap TA, Tutt A, Wu P, Mergui-Roelvink M, Mortimer P, Swaisland H, Lau A, O'Connor MJ, Ashworth A, Carmichael J, Kaye SB, Schellens JH, de Bono JS: Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med. 2009, 361: 123-134. 10.1056/NEJMoa0900212.CrossRefPubMed Fong PC, Boss DS, Yap TA, Tutt A, Wu P, Mergui-Roelvink M, Mortimer P, Swaisland H, Lau A, O'Connor MJ, Ashworth A, Carmichael J, Kaye SB, Schellens JH, de Bono JS: Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med. 2009, 361: 123-134. 10.1056/NEJMoa0900212.CrossRefPubMed
4.
go back to reference Marcus JN, Watson P, Page DL, Narod SA, Tonin P, Lenoir GM, Serova O, Lynch HT: BRCA2 hereditary breast cancer pathophenotype. Breast Cancer Res Treat. 1997, 44: 275-277. 10.1023/A:1005830230664.CrossRefPubMed Marcus JN, Watson P, Page DL, Narod SA, Tonin P, Lenoir GM, Serova O, Lynch HT: BRCA2 hereditary breast cancer pathophenotype. Breast Cancer Res Treat. 1997, 44: 275-277. 10.1023/A:1005830230664.CrossRefPubMed
5.
go back to reference Lakhani SR, Jacquemier J, Sloane JP, Gusterson BA, Anderson TJ, van de Vijver MJ, Farid LM, Venter D, Antoniou A, Storger-Isser A, Smyth E, Steel CM, Haites N, Scott RJ, Goldgar D, Neuhausen S, Daly PA, Ormiston W, McManus R, Scherneck S, Ponder BA, Ford D, Peto J, Stoppa-Lyonnet D, Bignon YJ, Struewing JP, Spurr NK, Bishop DT, Klijn JG, Devilee P, et al: Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst. 1998, 90: 1138-1145. 10.1093/jnci/90.15.1138.CrossRefPubMed Lakhani SR, Jacquemier J, Sloane JP, Gusterson BA, Anderson TJ, van de Vijver MJ, Farid LM, Venter D, Antoniou A, Storger-Isser A, Smyth E, Steel CM, Haites N, Scott RJ, Goldgar D, Neuhausen S, Daly PA, Ormiston W, McManus R, Scherneck S, Ponder BA, Ford D, Peto J, Stoppa-Lyonnet D, Bignon YJ, Struewing JP, Spurr NK, Bishop DT, Klijn JG, Devilee P, et al: Multifactorial analysis of differences between sporadic breast cancers and cancers involving BRCA1 and BRCA2 mutations. J Natl Cancer Inst. 1998, 90: 1138-1145. 10.1093/jnci/90.15.1138.CrossRefPubMed
6.
go back to reference Johannsson OT, Idvall I, Anderson C, Bord A, Barkardottir RB, Egilsson V, Olsson H: Tumour biological features of BRCA1-induced breast and ovarian cancer. Eur J Cancer. 1997, 33: 362-371. 10.1016/S0959-8049(97)89007-7.CrossRefPubMed Johannsson OT, Idvall I, Anderson C, Bord A, Barkardottir RB, Egilsson V, Olsson H: Tumour biological features of BRCA1-induced breast and ovarian cancer. Eur J Cancer. 1997, 33: 362-371. 10.1016/S0959-8049(97)89007-7.CrossRefPubMed
7.
go back to reference Foulkes WD, Stefansson IM, Chappuis PO, Begin LR, Goffin JR, Wong N, Trudel M, Akslen LA: Germline BRCA1 mutations and a basal epithelial phenotype in breast cancer. J Natl Cancer Inst. 2003, 95: 1482-1485. 10.1093/jnci/djg050.CrossRefPubMed Foulkes WD, Stefansson IM, Chappuis PO, Begin LR, Goffin JR, Wong N, Trudel M, Akslen LA: Germline BRCA1 mutations and a basal epithelial phenotype in breast cancer. J Natl Cancer Inst. 2003, 95: 1482-1485. 10.1093/jnci/djg050.CrossRefPubMed
8.
go back to reference Kennedy RD, Quinn JE, Mullan PB, Johnston PG, Harkin DP: The role of BRCA1 in the cellular response to chemotherapy. J Natl Cancer Inst. 2004, 96: 1659-1668. 10.1093/jnci/djh312.CrossRefPubMed Kennedy RD, Quinn JE, Mullan PB, Johnston PG, Harkin DP: The role of BRCA1 in the cellular response to chemotherapy. J Natl Cancer Inst. 2004, 96: 1659-1668. 10.1093/jnci/djh312.CrossRefPubMed
9.
go back to reference Turner N, Tutt A, Ashworth A: Targeting the DNA repair defect of BRCA tumours. Curr Opin Pharmacol. 2005, 5: 388-393. 10.1016/j.coph.2005.03.006.CrossRefPubMed Turner N, Tutt A, Ashworth A: Targeting the DNA repair defect of BRCA tumours. Curr Opin Pharmacol. 2005, 5: 388-393. 10.1016/j.coph.2005.03.006.CrossRefPubMed
10.
go back to reference Górski B, Byrski T, Huzarski T, Jakubowska A, Menkiszak J, Gronwald J, Pluzanski A, Bebenek M, Fischer-Maliszewska L, Grzybowska E, Narod SA, Lubinski J: Founder mutations in BRCA1 gene in Polish families with breast-ovarian cancer. Am J Hum Genet. 2000, 66: 1963-1968. 10.1086/302922.CrossRefPubMedPubMedCentral Górski B, Byrski T, Huzarski T, Jakubowska A, Menkiszak J, Gronwald J, Pluzanski A, Bebenek M, Fischer-Maliszewska L, Grzybowska E, Narod SA, Lubinski J: Founder mutations in BRCA1 gene in Polish families with breast-ovarian cancer. Am J Hum Genet. 2000, 66: 1963-1968. 10.1086/302922.CrossRefPubMedPubMedCentral
11.
go back to reference Górski B, Jakubowska A, Huzarski T, Byrski T, Gronwald J, Grzybowska E, Mackiewicz A, Stawaicka M, Bebenek M, Sorokin D, Fiszer-Maliszewska L, Haus O, Janiszewska H, Niepsuj S, Gozdz S, Zaremba L, Posmyk M, Pluzanska M, Kilar E, Czudowska D, Wasko B, Miturski R, Kowalczyk JR, Urbanski K, Szwiec M, Koc J, Debniak B, Rozmiarek A, Debniak T, Cybulski C, et al: A high proportion of founder BRCA1 mutations in Polish breast cancer families. Int J Cancer. 2004, 110: 683-686. 10.1002/ijc.20162.CrossRefPubMed Górski B, Jakubowska A, Huzarski T, Byrski T, Gronwald J, Grzybowska E, Mackiewicz A, Stawaicka M, Bebenek M, Sorokin D, Fiszer-Maliszewska L, Haus O, Janiszewska H, Niepsuj S, Gozdz S, Zaremba L, Posmyk M, Pluzanska M, Kilar E, Czudowska D, Wasko B, Miturski R, Kowalczyk JR, Urbanski K, Szwiec M, Koc J, Debniak B, Rozmiarek A, Debniak T, Cybulski C, et al: A high proportion of founder BRCA1 mutations in Polish breast cancer families. Int J Cancer. 2004, 110: 683-686. 10.1002/ijc.20162.CrossRefPubMed
12.
go back to reference Lubinski J, Gorski B, Huzarski T, Byrski T, Gronwald J, Serrano-Fernandez P, Domagala W, Chosia M, Ucinski M, Grzybowska E, Lange D, Maka B, Mackiewicz A, Karczewska A, Breborowicz J, Lamperska K, Stawicka M, Gozdecka-Grodecka S, Bebenek M, Sorokin D, Wojnar A, Haus O, Sir J, Mierzwa T, Niepsuj S, Gugala K, Gozdz S, Sygut J, Kozak-Klonowska B, Musiatowicz B, et al: BRCA1-positive breast cancers in young women from Poland. Breast Cancer Res Treat. 2006, 99: 71-76. 10.1007/s10549-006-9182-3.CrossRefPubMed Lubinski J, Gorski B, Huzarski T, Byrski T, Gronwald J, Serrano-Fernandez P, Domagala W, Chosia M, Ucinski M, Grzybowska E, Lange D, Maka B, Mackiewicz A, Karczewska A, Breborowicz J, Lamperska K, Stawicka M, Gozdecka-Grodecka S, Bebenek M, Sorokin D, Wojnar A, Haus O, Sir J, Mierzwa T, Niepsuj S, Gugala K, Gozdz S, Sygut J, Kozak-Klonowska B, Musiatowicz B, et al: BRCA1-positive breast cancers in young women from Poland. Breast Cancer Res Treat. 2006, 99: 71-76. 10.1007/s10549-006-9182-3.CrossRefPubMed
13.
go back to reference Byrski T, Huzarski T, Dent R, Gronwald J, Cybulski C, Lubinski J, Narod SA: Response to neoadjuvant therapy with Cisplatin in BRCA1-Positive breast cancer patients. Breast Cancer Res Treat. 2009, 115: 359-363. 10.1007/s10549-008-0128-9.CrossRefPubMed Byrski T, Huzarski T, Dent R, Gronwald J, Cybulski C, Lubinski J, Narod SA: Response to neoadjuvant therapy with Cisplatin in BRCA1-Positive breast cancer patients. Breast Cancer Res Treat. 2009, 115: 359-363. 10.1007/s10549-008-0128-9.CrossRefPubMed
14.
go back to reference Therasse P, Arbuck SG, Eisenhauser EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92: 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed Therasse P, Arbuck SG, Eisenhauser EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, Van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000, 92: 205-216. 10.1093/jnci/92.3.205.CrossRefPubMed
15.
go back to reference Kelland L: The resurgence of platinum based cancer chemotherapy. Nat Rev Cancer. 2007, 7: 573-584. 10.1038/nrc2167.CrossRefPubMed Kelland L: The resurgence of platinum based cancer chemotherapy. Nat Rev Cancer. 2007, 7: 573-584. 10.1038/nrc2167.CrossRefPubMed
16.
go back to reference Sledge GW, Loehrer PJ, Roth BJ, Einhorn LH: Cisplatin as first-line therapy for metastatic breast cancer. J Clin Oncol. 1988, 6: 1811-1818.PubMed Sledge GW, Loehrer PJ, Roth BJ, Einhorn LH: Cisplatin as first-line therapy for metastatic breast cancer. J Clin Oncol. 1988, 6: 1811-1818.PubMed
17.
go back to reference Kriege M, Seynaeve C, Meijers-Heijboer H, Collee JM, Menke-Pluymers MB, Bartels CC, Tilanus-Linthorst MM, Blom J, Huijskens E, Jager A, van den Ouweland A, van Geel B, Hoonng MJ, Brekelmans CT, Klijn JG: Sensitivity to first-line chemotherapy for metastatic breast cancer in BRCA1 and BRCA2 mutation carriers. J Clin Oncol. 2009, 27: 3764-3771. 10.1200/JCO.2008.19.9067.CrossRefPubMed Kriege M, Seynaeve C, Meijers-Heijboer H, Collee JM, Menke-Pluymers MB, Bartels CC, Tilanus-Linthorst MM, Blom J, Huijskens E, Jager A, van den Ouweland A, van Geel B, Hoonng MJ, Brekelmans CT, Klijn JG: Sensitivity to first-line chemotherapy for metastatic breast cancer in BRCA1 and BRCA2 mutation carriers. J Clin Oncol. 2009, 27: 3764-3771. 10.1200/JCO.2008.19.9067.CrossRefPubMed
18.
go back to reference Tutt A, Robson M, Garber JE, Domchek SM, Audeh MW, Weitzel JN, Friedlander M, Arun B, Loman N, Schmutzler RK, Wardley A, Mitchell G, Earl H, Wickens M, Carmichael J: Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and advanced breast cancer: a proof-of-concept trial. Lancet. 2010, 376: 235-244. 10.1016/S0140-6736(10)60892-6.CrossRefPubMed Tutt A, Robson M, Garber JE, Domchek SM, Audeh MW, Weitzel JN, Friedlander M, Arun B, Loman N, Schmutzler RK, Wardley A, Mitchell G, Earl H, Wickens M, Carmichael J: Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and advanced breast cancer: a proof-of-concept trial. Lancet. 2010, 376: 235-244. 10.1016/S0140-6736(10)60892-6.CrossRefPubMed
19.
go back to reference Byrski T, Gronwald J, Huzarski T, Grzybowska E, Budryk M, Stawicka M, Mierzwa T, Szwiec M, Wisniowski R, Siolek M, Dent R, Lubinski J, Narod S: Pathological complete response rates in young women with BRCA1-positive breast cancers after neoadjuvant chemotherapy. J Clin Oncol. 2010, 28: 375-379. 10.1200/JCO.2008.20.7019.CrossRefPubMed Byrski T, Gronwald J, Huzarski T, Grzybowska E, Budryk M, Stawicka M, Mierzwa T, Szwiec M, Wisniowski R, Siolek M, Dent R, Lubinski J, Narod S: Pathological complete response rates in young women with BRCA1-positive breast cancers after neoadjuvant chemotherapy. J Clin Oncol. 2010, 28: 375-379. 10.1200/JCO.2008.20.7019.CrossRefPubMed
20.
go back to reference Tan DS, Rothermundt C, Thomas K, Bancroft E, Eeles R, Shanley S, Ardern-Jones A, Norman A, Kaye SB, Gore ME: BRCAness syndrome in ovarian cancer: a case-control study describing the clinical features and outcome of patients with epithelial ovarian cancer associated with BRCA1 and BRCA2 mutations. J Clin Oncol. 2008, 26: 5530-5536. 10.1200/JCO.2008.16.1703.CrossRefPubMed Tan DS, Rothermundt C, Thomas K, Bancroft E, Eeles R, Shanley S, Ardern-Jones A, Norman A, Kaye SB, Gore ME: BRCAness syndrome in ovarian cancer: a case-control study describing the clinical features and outcome of patients with epithelial ovarian cancer associated with BRCA1 and BRCA2 mutations. J Clin Oncol. 2008, 26: 5530-5536. 10.1200/JCO.2008.16.1703.CrossRefPubMed
21.
go back to reference Cass I, Baldwin RL, Varkey T, Moslehi R, Narod SA, Karlan BY: Improved survival in women with BRCA-associated ovarian carcinoma. Cancer. 2003, 97: 2187-2195. 10.1002/cncr.11310.CrossRefPubMed Cass I, Baldwin RL, Varkey T, Moslehi R, Narod SA, Karlan BY: Improved survival in women with BRCA-associated ovarian carcinoma. Cancer. 2003, 97: 2187-2195. 10.1002/cncr.11310.CrossRefPubMed
22.
go back to reference Swisher EM, Sakai W, Karlan BY, Wurz K, Urban N, Taniguchi T: Secondary BRCA1 mutations in BRCA1-mutated ovarian carcinomas with platinum resistance. Cancer Res. 2008, 68: 2581-2586. 10.1158/0008-5472.CAN-08-0088.CrossRefPubMedPubMedCentral Swisher EM, Sakai W, Karlan BY, Wurz K, Urban N, Taniguchi T: Secondary BRCA1 mutations in BRCA1-mutated ovarian carcinomas with platinum resistance. Cancer Res. 2008, 68: 2581-2586. 10.1158/0008-5472.CAN-08-0088.CrossRefPubMedPubMedCentral
23.
go back to reference Drost R, Bouwman P, Rottenberg S, Boon U, Schut E, Klarenbeek S, Klijn C, van der Heijden I, van der Gulden H, Wientjens E, Pieterse M, Catteau A, Green P, Solomon E, Morris JR, Jonkers J: BRCA1 RING function is essential for tumor suppression but dispensable for therapy resistance. Cancer Cell. 2011, 20: 797-809. 10.1016/j.ccr.2011.11.014.CrossRefPubMed Drost R, Bouwman P, Rottenberg S, Boon U, Schut E, Klarenbeek S, Klijn C, van der Heijden I, van der Gulden H, Wientjens E, Pieterse M, Catteau A, Green P, Solomon E, Morris JR, Jonkers J: BRCA1 RING function is essential for tumor suppression but dispensable for therapy resistance. Cancer Cell. 2011, 20: 797-809. 10.1016/j.ccr.2011.11.014.CrossRefPubMed
24.
go back to reference Ghadirian P, Robidoux A, Zhang P, Royer R, Akbari M, Zhang S, Fafard E, Costa M, Martin G, Potvin C, Patocskai E, Larouche N, Younan R, Nassif E, Giroux S, Narod SA, Rousseau F, Foulkes WD: The contribution of founder mutations to early-onset breast cancer in French-Canadian women. J Clin Genet Clin Genet. 2009, 76: 421-426.CrossRef Ghadirian P, Robidoux A, Zhang P, Royer R, Akbari M, Zhang S, Fafard E, Costa M, Martin G, Potvin C, Patocskai E, Larouche N, Younan R, Nassif E, Giroux S, Narod SA, Rousseau F, Foulkes WD: The contribution of founder mutations to early-onset breast cancer in French-Canadian women. J Clin Genet Clin Genet. 2009, 76: 421-426.CrossRef
Metadata
Title
Results of a phase II open-label, non-randomized trial of cisplatin chemotherapy in patients with BRCA1-positive metastatic breast cancer
Authors
Tomasz Byrski
Rebecca Dent
Pawel Blecharz
Malgorzata Foszczynska-Kloda
Jacek Gronwald
Tomasz Huzarski
Cezary Cybulski
Elzbieta Marczyk
Robert Chrzan
Andrea Eisen
Jan Lubinski
Steven A Narod
Publication date
01-08-2012
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 4/2012
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr3231

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