Chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early breast cancer
Abstract
BACKGROUND: Evidence to guide (neo)adjuvant chemotherapy choices in carriers of germline BRCA1/BRCA2 pathogenic variants (BRCA carriers) with early breast cancer (BC) is limited. We evaluated the association of different chemotherapy regimens with survival outcomes in this population. METHODS: The BRCA BCY Collaboration (NCT03673306) is an international, multicenter, retrospective cohort study of BRCA carriers diagnosed with stage I-III BC at age ≤ 40 years, between 2000 and 2020. Disease-free survival (DFS) and overall survival (OS) were assessed among patients with HER2-negative disease treated with anthracycline-taxane, anthracycline-no-taxane, or non-anthracycline (neo)adjuvant chemotherapy. The association of platinum use with outcomes was evaluated in triple-negative breast cancer (TNBC). RESULTS: Among 4200 young BRCA carriers from 109 centres who received (neo)adjuvant chemotherapy for HER2-negative BC, 58.7% had TNBC. Median follow-up was 8.1 years (IQR, 4.7-12.6 years). Anthracycline-taxane, anthracycline-no-taxane, and non-anthracycline regimens were used in 74.4%, 19.3%, and 6.3% of patients, respectively. Platinum agents were administered in 19.8% of TNBC cases. After multivariable adjustment, no significant differences in DFS or OS were observed between anthracycline-no-taxane and anthracycline-taxane regimens (DFS adjusted hazard ratio [aHR] 0.88, 95% CI 0.73-1.05; OS aHR 1.20, 95% CI 0.87-1.67) or non-anthracycline regimens (DFS aHR 1.07, 95% CI 0.82-1.38; OS aHR 1.16, 95% CI 0.68-2.0). In TNBC, platinum use was not associated with improved outcomes. CONCLUSIONS: In young BRCA carriers with HER2-negative early BC, no statistically significant differences in survival outcomes were detected across different chemotherapy regimens. Our findings may inform future prospective studies evaluating chemotherapy de-escalation strategies in this genetically defined population.
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BibTeX
@article{bernsteinmolho2026chemotherapy,
title = {{Chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early breast cancer}},
author = {Rinat Bernstein-Molho and Tal Sella and Virginia Delucchi and Florence Coussy and Hee Jeong Kim and Sabine Linn and Antonio Di Meglio and Katarzyna Pogoda and Ava Kwong and Elisa Agostinetto and Jyoti Bajpai and Yannick van Herck and Alberta Ferrari and Judith Balmana and Halle Moore and Fedro Peccatori and Ann Partridge and Melina Winocur and Tiphaine Renaud and Christine Rousset-Jablonski and Jeong Eon Lee and Angela Toss and Shani Paluch-Shimon and Stephanie Wong and Alexios Matikas and Cynthia Villarreal-Garza and Claudio Vernieri and Minna Lee and Deniz Can Guven and Wanda Cui and Kathryn Ruddy and Maria Vittoria Dieci and Robert Fruscio and Laura de Marchis and Zoe Kemp and Pedro Meireles and Maria Grazia Razeti and Maria del Pilar Diz and Shelley Hwang and Fabio Puglisi and Florian Clatot and Rinat Yerushalmi and Natalia Cichowska-Cwalinska and Alessandra Chirco and Carmine de Angelis and Eva Blondeaux and Matteo Lambertini and Halle C.F. Moore},
journal = {European Journal of Cancer},
year = {2026},
month = sep,
doi = {10.1016/j.ejca.2026.116937},
url = {https://hal.science/hal-05750637v1},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Chemotherapy type and survival in young BRCA1/2 carriers with HER2-negative early breast cancer
AU - Rinat Bernstein-Molho
AU - Tal Sella
AU - Virginia Delucchi
AU - Florence Coussy
AU - Hee Jeong Kim
AU - Sabine Linn
AU - Antonio Di Meglio
AU - Katarzyna Pogoda
AU - Ava Kwong
AU - Elisa Agostinetto
AU - Jyoti Bajpai
AU - Yannick van Herck
AU - Alberta Ferrari
AU - Judith Balmana
AU - Halle Moore
AU - Fedro Peccatori
AU - Ann Partridge
AU - Melina Winocur
AU - Tiphaine Renaud
AU - Christine Rousset-Jablonski
AU - Jeong Eon Lee
AU - Angela Toss
AU - Shani Paluch-Shimon
AU - Stephanie Wong
AU - Alexios Matikas
AU - Cynthia Villarreal-Garza
AU - Claudio Vernieri
AU - Minna Lee
AU - Deniz Can Guven
AU - Wanda Cui
AU - Kathryn Ruddy
AU - Maria Vittoria Dieci
AU - Robert Fruscio
AU - Laura de Marchis
AU - Zoe Kemp
AU - Pedro Meireles
AU - Maria Grazia Razeti
AU - Maria del Pilar Diz
AU - Shelley Hwang
AU - Fabio Puglisi
AU - Florian Clatot
AU - Rinat Yerushalmi
AU - Natalia Cichowska-Cwalinska
AU - Alessandra Chirco
AU - Carmine de Angelis
AU - Eva Blondeaux
AU - Matteo Lambertini
AU - Halle C.F. Moore
PY - 2026
DA - 2026/09/15
JO - European Journal of Cancer
DO - 10.1016/j.ejca.2026.116937
UR - https://hal.science/hal-05750637v1
AB - BACKGROUND: Evidence to guide (neo)adjuvant chemotherapy choices in carriers of germline BRCA1/BRCA2 pathogenic variants (BRCA carriers) with early breast cancer (BC) is limited. We evaluated the association of different chemotherapy regimens with survival outcomes in this population. METHODS: The BRCA BCY Collaboration (NCT03673306) is an international, multicenter, retrospective cohort study of BRCA carriers diagnosed with stage I-III BC at age ≤ 40 years, between 2000 and 2020. Disease-free survival (DFS) and overall survival (OS) were assessed among patients with HER2-negative disease treated with anthracycline-taxane, anthracycline-no-taxane, or non-anthracycline (neo)adjuvant chemotherapy. The association of platinum use with outcomes was evaluated in triple-negative breast cancer (TNBC). RESULTS: Among 4200 young BRCA carriers from 109 centres who received (neo)adjuvant chemotherapy for HER2-negative BC, 58.7% had TNBC. Median follow-up was 8.1 years (IQR, 4.7-12.6 years). Anthracycline-taxane, anthracycline-no-taxane, and non-anthracycline regimens were used in 74.4%, 19.3%, and 6.3% of patients, respectively. Platinum agents were administered in 19.8% of TNBC cases. After multivariable adjustment, no significant differences in DFS or OS were observed between anthracycline-no-taxane and anthracycline-taxane regimens (DFS adjusted hazard ratio [aHR] 0.88, 95% CI 0.73-1.05; OS aHR 1.20, 95% CI 0.87-1.67) or non-anthracycline regimens (DFS aHR 1.07, 95% CI 0.82-1.38; OS aHR 1.16, 95% CI 0.68-2.0). In TNBC, platinum use was not associated with improved outcomes. CONCLUSIONS: In young BRCA carriers with HER2-negative early BC, no statistically significant differences in survival outcomes were detected across different chemotherapy regimens. Our findings may inform future prospective studies evaluating chemotherapy de-escalation strategies in this genetically defined population.
SN - 0959-8049
ER -