Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data.
Antineoplastic Agents
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Biomarkers, Tumor
/ analysis
Carboplatin
/ therapeutic use
Disease-Free Survival
Fallopian Tube Neoplasms
/ drug therapy
Female
Humans
Neoadjuvant Therapy
Neoplasms, Cystic, Mucinous, and Serous
/ drug therapy
Ovarian Neoplasms
/ drug therapy
Treatment Outcome
Chemotherapy response score
High-grade serous tubo-ovarian cancer
Neoadjuvant chemotherapy
Prognosis
Journal
Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
05
02
2019
revised:
21
04
2019
accepted:
24
04
2019
pubmed:
24
5
2019
medline:
15
10
2019
entrez:
24
5
2019
Statut:
ppublish
Résumé
There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT. We established an international collaboration to conduct a systematic review and meta-analysis, pooling individual patient data from 16 sites in 11 countries. Patients had stage IIIC/IV HGSC, 3-4 NACT cycles and >6-months follow-up. Random effects models were used to derive combined odds ratios in the pooled population to investigate associations between CRS and progression free and overall survival (PFS and OS). 877 patients were included from published and unpublished studies. Median PFS and OS were 15 months (IQR 5-65) and 28 months (IQR 7-92) respectively. CRS3 was seen in 249 patients (28%). The pooled hazard ratios (HR) for PFS and OS for CRS3 versus CRS1/CRS2 were 0·55 (95% CI, 0·45-0·66; P < 0·001) and 0·65 (95% CI 0·50-0·85, P = 0·002) respectively; no heterogeneity was identified (PFS: Q = 6·42, P = 0·698, I2 = 0·0%; OS: Q = 6·89, P = 0·648, I2 = 0·0%). CRS was significantly associated with PFS and OS in multivariate models adjusting for age and stage. Of 306 patients with known germline BRCA1/2 status, those with BRCA1/2 mutations (n = 80) were more likely to achieve CRS3 (P = 0·027). CRS3 was significantly associated with improved PFS and OS compared to CRS1/2. This validation of CRS in a real-world setting demonstrates it to be a robust and reproducible biomarker with potential to be incorporated into therapeutic decision-making and clinical trial design.
Identifiants
pubmed: 31118141
pii: S0090-8258(19)31181-3
doi: 10.1016/j.ygyno.2019.04.679
pii:
doi:
Substances chimiques
Antineoplastic Agents
0
Biomarkers, Tumor
0
Carboplatin
BG3F62OND5
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-448Subventions
Organisme : Cancer Research UK
ID : 13034
Pays : United Kingdom
Investigateurs
Simi Aggarwal
(S)
Holger Bronger
(H)
Elizabeth B Brown
(EB)
Martin Buck
(M)
Syed A Bukhari
(SA)
Edwina Coghlan
(E)
Nichola Cope
(N)
Michelle Samora de Almeida
(MS)
Cornelius D De Kroon
(CD)
Andrew Dean
(A)
Michael-John Devlin
(MJ)
Helena M Ditzel
(HM)
Enken Drecoll
(E)
Takahiro Ebata
(T)
Anna Fagotti
(A)
Asma Faruqi
(A)
Laura Feeney
(L)
Kavita Gupta
(K)
Ian Harley
(I)
Frediano Inzani
(F)
Arjun R Jeyarajah
(AR)
M H Eleanor Koay
(MHE)
Judith R Kroep
(JR)
Jung-Yun Lee
(JY)
Yee Leung
(Y)
Michelle Lockley
(M)
Alice R Loft
(AR)
Daniel MaGee
(D)
Ranjit Manchanda
(R)
Sarah McKenna
(S)
Divya Midha
(D)
David Millan
(D)
Joanne Millar
(J)
Rowan Miller
(R)
Ganendra R Mohan
(GR)
Sohail Mughal
(S)
Asima Mukhopadhyay
(A)
Sergio Mancini Nicolau
(SM)
James Nevin
(J)
Abigail S Oakley
(AS)
Mary Quigley
(M)
Bhavana Rai
(B)
Arvind Rajwanshi
(A)
Stuart G Salfinger
(SG)
Giovanni Scambia
(G)
Kate Scatchard
(K)
Barbara Schmalfeldt
(B)
Bryony Simcock
(B)
Priya Singh
(P)
Kyle C Strickland
(KC)
Vainta Suri
(V)
Sheeba Syed
(S)
Peter Sykes
(P)
Kenji Tamura
(K)
Adeline Tan
(A)
Jason Tan
(J)
Emily Thompson
(E)
Anna V Tinker
(AV)
Georgia Trevisan
(G)
Maria Gabriela Baumgarten Kuster Uyeda
(MGBK)
Michelle M Vaughan
(MM)
Wilko Weichert
(W)
Anthony Williams
(A)
Sarah Williams
(S)
Hiroshi Yoshida
(H)
Pier Carlo Zorzato
(PC)
Commentaires et corrections
Type : ErratumIn
Type : ErratumIn
Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.