Prevalence of BRCA1 and BRCA2 Mutations in Patients with Primary Ovarian Cancer - Does the German Checklist for Detecting the Risk of Hereditary Breast and Ovarian Cancer Adequately Depict the Need for Consultation?

Affiliations

PMID: 32905297
PMCID: PMC7467803
DOI: 10.1055/a-1222-0042

Free PMC article

Abstract

Background BRCA1/2 mutations are the leading cause of hereditary epithelial ovarian cancer (EOC). The German Consortium for Hereditary Breast and Ovarian Cancer has defined inclusion criteria, which are retrievable as a checklist and facilitate genetic counselling/testing for affected persons with a mutation probability of ≥ 10%. Our objective was to evaluate the prevalence of the BRCA1/2 mutation(s) based on the checklist score (CLS). Methods A retrospective data analysis was performed on EOC patients with a primary diagnosis treated between 1/2011 - 5/2019 at the Central Essen Clinics, where a BRCA1/2 genetic analysis result and a CLS was available. Out of 545 cases with a BRCA1/2 result (cohort A), 453 cases additionally had an extended gene panel result (cohort B). Results A BRCA1/2 mutation was identified in 23.3% (127/545) in cohort A, pathogenic mutations in non- BRCA1/2 genes were revealed in a further 6.2% in cohort B. In cohort A, 23.3% (127/545) of patients had a BRCA1 (n = 92) or BRCA2 (n = 35) mutation. Singular EOC (CLS 2) was present in 40.9%. The prevalence for a BRCA1/2 mutation in cohort A was 10.8%, 17.2%, 25.0%, 35.1%, 51.4% and 66.7% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively. The mutation prevalence in cohort B was 15.9%, 16.4%, 28.2%, 40.4%, 44.8% and 62.5% for patients with CLS 2, 3, 4, 5, 6 and ≥ 7 respectively. Conclusions The BRCA1/2 mutation prevalence in EOC patients positively correlates with a rising checklist score. Already with singular EOC, the prevalence of a BRCA1/2 mutation exceeds the required 10% threshold. Our data support the recommendation of the S3 guidelines Ovarian Cancer of offering genetic testing to all patients with EOC. Optimisation of the checklist with clear identification of the testing indication in this population should therefore be aimed for.

Keywords: BRCA mutation; hereditary breast and ovarian cancer; heritability checklist; ovarian cancer.

Conflict of interest statement

Conflict of Interest/Interessenkonflikt BA (Consulting activities: Roche, Amgen, Tesaro; Advanced training/conferences/lecture honoraria: Roche, AstraZeneca, Tesaro, Clovis, Amgen, Celgene, PharmaMar). DT No conflicts of interest. KR (Consulting activities: AstraZeneca, Pfizer, Tesaro; Advanced training/conferences/lecture honoraria: AstraZeneca, Pfizer, Tesaro; Immaterial conflicts of interest/affiliation with scientific schools: German Consortium for Hereditary Breast and Ovarian Cancer). PH (Consulting activities: AstraZeneca, Roche, Sitio, Tesaro, Lilly, Clovis, MSD, Merck; Author activity/expert reviewer activity: AstraZeneca; Advanced training/conferences/lecture honoraria: AstraZeneca, Roche, Tesaro, Stryker, ZaiLab, MSD/Merck; Scientific activities: AstraZeneca, Roche DFG, EU, Genmab). StS (Consulting activities: Clovis, Tesaro; Advanced training/conferences/lecture honoraria: PharmaMar, Roche, Tesaro, Roche, AstraZeneca). FH (Consulting activities: AstraZeneca, Tesaro, Clovis; Advanced training/conferences/lecture honoraria: AstraZeneca, Tesaro, Clovis, Roche, PharmaMar). TB (Consulting activities: Tesaro; Advanced training/conferences/lecture honoraria: Roche, Amgen; Scientific activity: Amgen). AT No conflicts of interest. NP No conflicts of interest. SE (Non-financial support: Tesaro). HP No conflicts of interest. RS (Consulting activities: AstraZeneca; Advanced training/conferences/lecture honoraria: AstraZeneca; Scientific activities: AGO study group; Immaterial conflict of interest/affiliation with scientific schools: German Consortium for Hereditary Breast and Ovarian Cancer). AdB (Consulting activities: AstraZeneca, Clovis, Tesaro, Roche, Genmab, BIOCAD, Pfizer, MSD; Advanced training/conferences/lecture honoraria: AstraZeneca, Clovis, Tesaro; Scientific activities: AstraZeneca, Tesaro, Roche, Genmab, BIOCAD)./ BA (Beratertätigkeiten: Roche, Amgen, Tesaro; Fortbildung/Kongresse/Vortragshonorare: Roche, AstraZeneca, Tesaro, Clovis, Amgen, Celgene, PharmaMar). DT keine Interessenkonflikte. KR (Beratertätigkeiten: AstraZeneca, Pfizer, Tesaro; Fortbildung/Kongresse/Vortragshonorare: AstraZeneca, Pfizer, Tesaro; immaterielle Interessenkonflikte/Zugehörigkeit zu wissenschaftlichen Schulen: Deutsches Konsortium Familiärer Brust- und Eierstockkrebs). PH (Beratertätigkeiten: AstraZeneca, Roche, Sitio, Tesaro, Lilly, Clovis, MSD, Merck; AutorenTätigleit/Gutachtertätigkeit: AstraZeneca; Fortbildung/Kongresse/Vortragshonorare: AstraZeneca, Roche, Tesaro, Stryker, ZaiLab, MSD/Merck; wissenschaftliche Tätigkeiten: AstraZeneca, Roche DFG, EU, Genmab). StS (Beratertätigkeiten: Clovis, Tesaro; Fortbildung/Kongresse/Vortragshonorare: PharmaMar, Roche, Tesaro, Roche, AstraZeneca). FH (Beratertätigkeiten: AstraZeneca, Tesaro, Clovis; Fortbildung/Kongresse/Vortragshonorare: AstraZeneca, Tesaro, Clovis, Roche, PharmaMar). TB (Beratertätigkeiten: Tesaro; Fortbildung/Kongresse/Vortragshonorare: Roche, Amgen; wissenschaftliche Tätigkeit: Amgen). AT keine Interessenkonflikte. NP keine Interessenkonflikte. SE (nicht-finanzieller Support: Tesaro). HP keine Interessenkonflikte. RS (Beratertätigkeiten: AstraZeneca; Fortbildung/Kongresse/Vortragshonorare: AstraZeneca; wissenschaftliche Tätigkeiten: AGO Studiengruppe; immaterielle Interessenkonflikte/Zugehörigkeit zu wissenschaftlichen Schulen: Deutsches Konsortium Familiärer Brust- und Eierstockkrebs). AdB (Beratertätigkeiten: AstraZeneca, Clovis, Tesaro, Roche, Genmab, BIOCAD, Pfizer, MSD; Fortbildung/Kongresse/Vortragshonorare: AstraZeneca, Clovis, Tesaro; wissenschaftliche Tätigkeiten: AstraZeneca, Tesaro, Roche, Genmab, BIOCAD).