287 Background: BRCA1/2 mutation carriers with PC may have distinct biologic outcomes. We recently described favorable overall survival (OS) in patients with early-stage resected PC. However the prognostic impact of germline (GL) BRCA1/2 mutations in surgically-resected PC cases has not been yet compared with institution-matched controls. Methods: A multi-center, case-control retrospective analysis was performed of patients with surgically-resected, BRCA1/2 mutated PC from years 2001-2012. Non-hereditary PC controls were defined as BRCA negative or absence of a personal and first degree familial history of breast, ovarian or PC. Cases were matched by: age at diagnosis (+/- 5 years), treatment (neoadjuvant vs. adjuvant) and institution. Demographics, clinical history, overall survival (OS) and disease-free survival (DFS) were abstracted from patient records. Statistical comparisons were assessed using χ2and Fisher's exact test and median DFS/OS using Kaplan-Meier method and log-rank testing. Results: 20 patients with GL BRCA1/2 mutation PC were identified and matched (1:2) with 40 non-hereditary controls. Cases were comparable to controls in all tumor and treatment (neoadjuvant vs. adjuvant) related variables except lymphovascular involvement (30.6% vs 64.7%, p= 0.014). However, BRCA cases frequently received neoadjuvant (8/10 vs 6/14)/adjuvant (7/15 vs 3/34) platinum-based treatment. Clinical characteristics of GL BRCA1/2PC cases: BRCA1=3, BRCA2=17. Mean age was 56.7 years (41-78, SD 10.0), 65% (n=13) were female, 55% (n=11) were Jewish, 55% (n=11) had a family history and 95% (n=19) were stage II at resection. We demonstrated no difference in median OS (23.8 vs 25.9 months, p=0.397) and in DFS (13.6 vs 12.6 months, p=0.404) in BRCA1/2 mutation carriers vs controls. BRCA1/2mutation carriers did not experience improved DFS or OS with platinum-based chemotherapy. Conclusions: In this retrospective analysis, the prognosis of surgically-resectable BRCA associated PC is no different than that of sporadic PC from the same institution. The role of DNA damaging agents in this setting is still inconclusive.
Overall survival and clinical characteristics of BRCA mutation carriers with stage I/II pancreatic cancer
