title: A high response rate to liposomal doxorubicin is seen among women with BRCA mutations treated for recurrent epithelial ovarian cancer.
abstract: OBJECTIVE
  Ten percent of ovarian cancer is attributed to hereditary syndromes, most commonly to mutations in the BRCA1 or BRCA2 genes. These cancers are characterized by a prolonged sensitivity to platinum agents in spite of presentation at advanced stages. We hypothesized that women with BRCA-associated ovarian cancer would also show a high response rate to pegylated liposomal doxorubicin (Doxil).
  
  
  METHODS
  A retrospective cohort study was conducted to compare the response rate, progression-free, and overall survival among women with BRCA-associated or sporadic ovarian cancer who were treated with Doxil.
  
  
  RESULTS
  A response to Doxil was seen in 13 of 23 patients with BRCA mutations (56.5%; 3 by RECIST criteria and 10 by CA125 levels) compared with only 8 of 41 women with non-hereditary cancers (19.5%; 2 by RECIST criteria and 6 by CA125 levels; p=0.004). This was associated with an improved progression-free and overall survival as measured from the time of Doxil administration. Notably, platinum sensitivity did not directly correlate with a response to Doxil.
  
  
  CONCLUSIONS
  Women with BRCA-associated ovarian tumors demonstrate a greater sensitivity to cytotoxic therapy with Doxil than has previously been reported in unselected cases.
authors.affiliation: Division of Gynecologic Oncology, The University of Pennsylvania Hospitals, 3400 Spruce Street, Philadelphia, PA 19104, USA. sadams@obgyn.upenn.edu
authors.forename: Sarah F
authors.initials: SF
authors.lastname: Adams
authors.forename: Evelyn B
authors.initials: EB
authors.lastname: Marsh
authors.forename: Wafic
authors.initials: W
authors.lastname: Elmasri
authors.forename: Steffanie
authors.initials: S
authors.lastname: Halberstadt
authors.forename: Stephanie
authors.initials: S
authors.lastname: Vandecker
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Angela R
authors.initials: AR
authors.lastname: Bradbury
authors.forename: Mary
authors.initials: M
authors.lastname: Daly
authors.forename: Beth
authors.initials: B
authors.lastname: Karlan
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D018095:Germ-Line Mutation; D006801:Humans; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000188:drug therapy* / Q000235:genetics*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin