Low testing rates and high BRCA prevalence: Poly (ADP-ribose) polymerase inhibitor use in Middle East BRCA/homologous recombination deficiency-positive cancer patients

Table 1 Demographics and clinical characteristics of germline BRCA-positive and BRCA-negative breast cancer

gBRCA1	Positive	Negative
Total, n (%)	15 (26.3)	42 (73.7)
Age in yr at diagnosis, mean ± SD	42.1 ± 11	45.3 ± 8.7
Positive family history, n (%)	8 (53.3)	16 (38.1)
First-degree relative, n (%)	8 (53.3)	9 (21.3)
Non-first-degree relatives, n (%)	4 (26.6)	11 (26.1)
H/o IVF & Rx, n (%)	0	0
H/o hormone Rx, n (%)	1 (6.6)	4 (9.5)
ECOG PS at diagnosis2, n (%)
0	13 (86.7)	40 (95.2)
1	2 (12.3)	2 (4.8)
Histology at diagnosis, n (%)
Invasive ductal carcinoma	12 (80)	35 (83.3)
Invasive lobular carcinoma	1 (6.6)	4 (9.5)
Grade at diagnosis, mean ± SD	3 ± 0.6	2 ± 0.7
Stage at diagnosis, n (%)
1	1 (6.6)	0
2	7 (46.6)	21 (50)
3	4 (26.6)	13 (31)
4	3 (20)	8 (19)
Categories3, n (%)
HER2-positive	4 (26.6)	12 (28.7)
Triple-negative	3 (20)	8 (19.0)
HR-positive and HER2-negative	6 (40)	15 (35.7)
HR-positive and HER2-positive	3 (20)	6 (14.3)

¹Includes BRCA1 and BRCA2.

²Eastern Cooperative Oncology Group Performance Status.

³Categories of breast cancer having prognostic significance.

ECOG PS: Eastern Cooperative Oncology Group Performance Status; HER2: Human epidermal growth factor receptor 2; HR: Homologous recombination; IVF: In vitro fertilization; Rx: Medical prescription.

Table 2 Clinical outcomes of poly (ADP-ribose) polymerase inhibitor therapy in BRCA gene-positive breast cancer and homologous recombination deficiency-positive ovarian cancer patients

Cancer type	Patient	Stage	Response change to PARPi	Duration of PARPi	PARPi status at end of study
BRCA+ breast cancer, 5/15 (33.3%)	1	II	CR–DF	13 months+	On Rx
	21	II	PR–PR	40 days	Stopped
	3	III	CR–DF	17 months+	On Rx
	4	IV	PR–PR	5 months	Stopped
	52	IV	PR	7 months	Stopped
HRD+ ovarian cancer, 4/6 (66.6%)	1	III	PR–DF	15 months+	On Rx
	2	IV	CR–DF	13 months+	On Rx
	3	IV	SD–PRF	20 months+	On Rx
	4	IV	CR–DF	25 months+	On Rx

¹Received three cycles of neoadjuvant chemotherapy and then lost to follow-up and received poly (ADP-ribose) polymerase inhibitor in the advanced stage.

²Received olaparib as first line. + indicates the status of still receiving poly (ADP-ribose) polymerase inhibitor at the time of data collection/study end.

CR: Complete remission, DF: Disease-free; HRD: Homologous recombination deficiency; PR: Partial response; PRF: Progression-free; SD: Stable disease.

Table 3 Demographic and clinical characteristics of homologous recombination deficiency-positive and -negative ovarian cancer

Characteristic	HRD-positive	HRD-negative
Total, n (%)	6 (24)	19 (76)
Age years at diagnosis, mean ± SD	56.5 ± 11	52.5 ± 13
Positive family history, n (%)	0	5 (26.3)
ECOG PS at diagnosis, n (%)
0	5 (83.3)	17 (89.4)
1	1 (16.7)	1 (5.3)
2	0	1 (5.3)
Histology, n (%)
Serous	5 (83.3)	9 (47.3)
Endometrioid/mucinous/clear cell	1 (16.7)	5 (26.3)
Mixed	0	5 (26.3)
Grade of cancer, mean ± SD	4 ± 0	4 ± 0.9
Stage of cancer, n (%)
1	1 (16.7)	2 (10.5)
2	0	0
3	2 (33.3)	11 (58)
4	3 (50)	6 (31.5)
Surgical Rx, n (%)	6 (100)	17 (89.5)
Primary	2 (33.3)	12 (63.1)
Interval	4 (66.7)	5 (26.4)

Of the 6 homologous recombination deficiency-positive cases, 3 had somatic BRCA gene mutations. ECOG PS: Eastern Cooperative Oncology Group Performance Status; HRD: Homologous recombination deficiency; Rx: Medical prescription.