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Background  To analyze the effects of  BRCA1/2  mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS).    Methods  We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline  BRCA1/2  test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018. Chemotherapy response scores were compared in patients with and without  BRCA1/2  mutations. The effects of  BRCA1/2  mutations and CRS on survival were evaluated.    Results   BRCA1/2  mutations were detected in 47 (28.1%) of the 169 patients. Overall, 16 (34.0%) patients with  BRCA1/2  mutations had a CRS 3 to chemotherapy compared to scores of 43 in patients (35.2%) without a mutation. Response scores of 3 in patients with  BRCA1/2  mutations were not significantly associated with either improved progression-free survival (PFS) ( P  = 0.949) or overall survival (OS) ( P  = 0.168). However, CRS 3 in patients without  BRCA  mutations was significantly associated with both improved PFS ( P  = 0.030) and OS ( P  = 0.039). In patients with CRS1/2, carriers of  BRCA1/2  mutations had better PFS ( P  = 0.0344) and OS ( P  = 0.043) than wild-type  BRCA  genotype patients.    Conclusion  In ovarian cancer patients treated with NAC, CRS did not predict survival for  BRCA 1/2  mutation carriers but did for  BRCA  wild-type patients.

Germline BRCA, chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer