Brain metastases in patients with ovarian cancer

Figures & data

Table 1. Demographics and clinical parameters of ovarian cancer patients.

Characteristics	Brain metastases N = 29^a,*	No brain metastases N = 1006^a	All N = 1035^a	p Value
Age at diagnosis, years, median (range)	59.8 (36.9–80.4)	61.2 (19.6–93.1)	61.1 (19.6–93.1)	0.543
Follow-up, months, median (range)	50.7 (13.7–174.8)	39.1 (0.03–422.5)	39.7 (0.03–422.5)	0.374
Stage at diagnosis, n (%)				0.027
I + II	2 (6.9%)	155/988 (15.7%)	157/1017 (15.4%)
III	17 (58.6%)	671/988 (67.9%)	688/1017 (38.2%)
IV	10 (34.5%)	162/988 (16.4%)	172/1017 (16.9%)
Histology, n (%)				0.926
Serous papillary^b	21 (72.4%)	636/916 (69.4%)	657/945 (69.5%)
Endometrioid	6 (20.7%)	201/916 (21.9%)	207/945 (21.9%)
Poorly differentiated/mucinous/clear cell	2 (6.9%)	79/916 (8.6%)	81/945 (8.6%)
Ethnicity, n (%)
Ashkenazi Jewish	17 (58.6%)	523/999 (52.4%)	540/1028 (52.5%)	0.783
Jewish non-Ashkenazi	9 (31.0%)	343/999 (34.3%)	352/1028 (34.2%)
Other	3 (10/3%)	133/999 (13.3%)	136/1028 (13.2%)
Tested for BRCA^c, n (%)	23 (79.3%)	703 (67.9%)	726 (70.1%)
BRCA wildtype	10/23 (43.5%)	461/703 (65.6%)	471/726 (64.9%)
BRCA mutations	13/23 (56.5%)	242/703 (34.4%)	255/726 (35.1%)	0.033
BRCA1	11/13 (84.6%)	169/242 (69.8%)	180/255 (70.6%)
BRCA2	2/13 (8.7%)	73/242 (30.2%)	75/255 (29.4%)
Optimal cytoreduction
R0	16/29 (55.2%)	628/1004 (62.5%)	644/1033 (62.3%)	0.136
R1	7/29 (24.1%)	222/1004 (22.1%)	229/1033 (22.2%)
R2	5/29 (17.2%)	82/1004 (8.1%)	87/1033 (8.4%)
No surgery	1/29 (3.0%)	72/1004 (7.2%)	73/1033 (7.1)
Number of treatment lines, median (range)	4 (1–12)	2 (1–11)	2 (1–12)	<0.0001
Platinum sensitivity, n (%)	26 (89.7%)	718/932 (77.0%)	744/961 (77.4%)	0.169
PARP inhibitors, n (%)	9 (31.0%)	117 (11.6%)	126 (24.4%)	0.004
Bevacizumab, n (%)	10 (34.5%)	246 (24.4%)	256 (24.7%)	0.308

^aThe denominator is indicated if it was different from the total number of subjects analyzed.

^bOnly patients with high-grade serous carcinoma were included in the analysis. None of the patients with low-grade serous carcinoma treated at our center had brain metastasis.

^cAll patients were referred for BRCA germline and somatic testing upon diagnosis. Some patients refused testing.

p values in bold indicate statistically significant differences between patients with brain metastases and those with no brain metastases.

Figure 1. Distribution of BRCA mutation status in patients with brain metastases. Hazard ratio = 3.029 (95%CI, 1.4–6.5), p = 0.0123.

Table 2. Comparison of OS by BM among the study population.

	All patients with BM N = 29	Patients with BM and BRCA1/2 mutation N = 13	Patients with BM and wildtype BRCA N = 10	p Value
Median time in months from diagnosis to BM, median (range)	31.0 (3.2–143.5)	44.3 (3.2–143.5)	26.4 (13.8–50.8)	0.044
Median time in months from disease recurrence to BM, median (range)	4.6 (12.0–100.4)	11.8 (12.0–95.5)	2.7 (0.1–24.9)	0.137
Median OS in months from BM diagnosis, median (95% CI)	59.43 (48.10–112.03)	20.6 (11.7–NE)	12.26 (7.36–NE)	0.441

BM: Brain metastases; CI: confidence interval; NE: not evaluable; OS: overall survival.

p values in bold indicate statistically significant differences between patients with brain metastases harboring a BRCA1/2 mutation and those with brain metastases and wildtype BRCA.

Figure 2. Overall survival of patients with ovarian cancer by brain metastases diagnosis. Kaplan–Meier survival analysis showing overall survival by brain metastases diagnosis in patients with ovarian cancer. p = 0.243. BM: Brain metastases.

Figure 3. Overall survival of ovarian cancer patients with BM by BRCA mutation status. Kaplan–Meier survival analysis showing overall survival in patients with ovarian cancer and BRCA wildtype that were diagnosed with brain metastases compared to patients with ovarian cancer harboring BRCA1/2 mutations that were diagnosed with brain metastases. p = 0.441.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.