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Abstract
Introduction. BRCA1-associated ovarian cancer (OC) is characterized by high sensitivity to DNA-damaging agents, however, the most effective drug therapy regimen is not defined.
Aim. To compare the clinical efficacy of the combination «mitomycin C and cisplatin» (MP) and «paclitaxel and carboplatin» (TCbP) in neoadjuvant therapy of BRCA-associated ovarian cancer in the randomized trial.
Methods. The study involved 98 patients with advanced ovarian cancer, who were treated at N.N. Petrov NMRC of Oncology (St Petersburg, Russia) from 2019 to 2020. Sixteen carriers of pathogenic variants of BRCA1 and BRCA2 were identified. The patients were randomized at the ratio 1:1 into the experimental group for chemotherapy with the combination of mitomycin C and cisplatin (MP), or into the control group for standard chemotherapy with the combination of paclitaxel and carboplatin (TCbP)
Results. All 8 patients of the advanced BRCA-associated ovarian cancer demonstrated the objective clinical response to treatment in the MP group, whereas only 4 of 8 (50%) patients acieved the same in the TCbP group. Complete and moderate pathomorphologic response (CRS2 and CRS3) was observed in all women in the MP group and only in 5 of 8 (62.5%) patients in the TCbP group.
Twelve patients receiving MP regimen 22 patients who followed the TCbP regimen were included for long term outcomes assessment. Median recurrence-free survival in the MP group was significantly higher than in the TCbP group: 27.3 months versus 17.4 months (p=0.048).
Conclusions. The combination of mitomycin C and cisplatin is superior to the «gold standard» of neoadjuvant chemotherapy in patients with BRCA-associated OC.
References
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