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International journal of clinical oncology · 2026

Association of germline BRCA and homologous recombination deficiency with hematologic toxicity during platinum-taxane chemotherapy in ovarian cancer.

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Yoshida Kosuke, Araki Hajime, Yamada Yurika, Masahashi Yoshiki, Miyamoto Emiri, Katayama Komei, Kubokawa Mei, Mogi Kazumasa, Yoshihara Masato, Nagao Yukari, Tamauchi Satoshi, Yokoi Akira, Yoshikawa Nobuhisa, Niimi Kaoru, Kajiyama Hiroaki

Аннотация

BACKGROUND: Germline BRCA (gBRCA) mutations and homologous recombination deficiency (HRD) are critical factors affecting treatment response; however, their association with hematologic toxicity remains controversial. This study assessed the interplay between these molecular features and hematologic adverse events during platinum-taxane chemotherapy.

METHODS: We retrospectively reviewed 62 patients with stage III-IV ovarian cancer between 2022 and 2024. After excluding 8 patients, 54 patients were stratified according to gBRCA and HRD status, and hematologic adverse events were evaluated for up to six treatment cycles. Moreover, meta-analysis was performed to integrate previously published data.

RESULTS: First, after excluding patients with uncertain gBRCA status, eight gBRCA mutation carriers were compared with 33 confirmed non-carriers. gBRCA mutation carriers tended to exhibit lower neutrophil counts during treatment; however, no statistically significant differences in hematologic toxicities were observed across treatment cycles. In the pooled meta-analysis, gBRCA mutation carriers demonstrated significantly increased odds of neutropenia (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.16-2.44) and G-CSF use (OR 3.09, 95% CI 1.19-8.03), whereas no significant associations were observed for anemia, thrombocytopenia, dose delay, or dose reduction. Second, 23 HRD-positive patients and 15 HRD-negative patients were analyzed. HRD-positive patients did not demonstrate increased hematologic toxicity compared with HRD-negative patients. Although baseline hemoglobin levels were lower in HRD-positive patients, these differences preceded chemotherapy initiation.

CONCLUSION: This study provides real-world evidence of a modestly increased risk of neutropenia and G-CSF use in gBRCA carriers during platinum-taxane chemotherapy; however, these differences did not appear to compromise treatment delivery.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты