ArticleInternational journal of clinical oncology2026
Association of germline BRCA and homologous recombination deficiency with hematologic toxicity during platinum-taxane chemotherapy in ovarian cancer.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGermline 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.
methodsWe 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.
resultsFirst, 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.
conclusionThis 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.
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