Chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early breast cancer
- Author(s)
- Bernstein-Molho, R; Sella, T; Delucchi, V; Coussy, F; Kim, HJ; Linn, S; Di Meglio, A; Pogoda, K; Kwong, A; Agostinetto, E; Bajpai, J; Van Herck, Y; Ferrari, A; Balmana, J; Moore, HCF; Peccatori, FA; Partridge, AH; Winocur, M; Renaud, T; Rousset-Jablonski, C; Lee, JE; Toss, A; Paluch-Shimon, S; Wong, SM; Matikas, A; Villarreal-Garza, C; Vernieri, C; Lee, M; Guven, DC; Cui, W; Ruddy, KJ; Dieci, MV; Fruscio, R; De Marchis, L; Kemp, Z; Meireles, PA; Razeti, MG; Diz, MDP; Hwang, SE; Puglisi, F; Clatot, F; Yerushalmi, R; Cichowska-Cwalinska, N; Chirco, A; De Angelis, C; Blondeaux, E; Lambertini, M;
- Journal Title
- European Journal of Cancer
- Publication Type
- Research article
- 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.
- Publisher
- Elsevier
- Keywords
- Humans; Female; Adult; Erb-b2 Receptor Tyrosine Kinases/metabolism; Retrospective Studies; *Antineoplastic Combined Chemotherapy Protocols/therapeutic use; *BRCA1 Protein/genetics; *Breast Neoplasms/drug therapy/genetics/mortality/pathology; *BRCA2 Protein/genetics; Anthracyclines/therapeutic use; Heterozygote; Chemotherapy, Adjuvant; Neoadjuvant Therapy/mortality; Disease-Free Survival; Taxoids/therapeutic use; Germ-Line Mutation; *Triple Negative Breast Neoplasms/drug therapy/genetics/pathology/mortality; Brca; Chemotherapy; Early breast cancer; Survival outcomes
- Department(s)
- Medical Oncology
- Publisher's Version
- https://doi.org/10.1016/j.ejca.2026.116937
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-09-03 12:44:09
Last Modified: 2026-09-03 12:44:21