Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data

Gian Franco Zannoni, Anna Fagotti, Giovanni Scambia, Frediano Inzani, Michelle Quigley, Barbara Praitano, Gian Rolando Trevisani, Manprietkaur Singh, Paul A. Cohen, Aime Powell, Steffen Böhm, C. Blake Gilks, Colin J.R. Stewart, Tarek M. Meniawy, Max Bulsara, Stefanie Avril, Eleanor C. Brockbank, Tjalling Bosse, Gustavo Rubino De Azevedo Focchi, Raji GanesanRosalind M. Glasspool, Brooke E. Howitt, Hyun-Soo Kim, Jung-Yun Lee, N. D. Le, Michelle Lockley, Ranjit Manchanda, Trupti Mandalia, W. Glenn Mccluggage, Iain Mcneish, D. Midha, Radhika Srinivasan, Yun Yi Tan, Rachael Van Der Griend, Mayu Yunokawa, Simi Aggarwal, Holger Bronger, Elizabeth B. Brown, Martin Buck, Syed A. Bukhari, Edwina Coghlan, Nichola Cope, Michelle Samora De Almeida, Cornelius D. De Kroon, Andrew Dean, Michael-John Devlin, Helena M. Ditzel, E. Drecoll, Asma Faruqi, L. Feeney, Kavita Gupta, Ian Harley, Arjun R. Jeyarajah, M.H. Eleanor Koay, Judith R. Kroep, Yee Leung, Alice R. Loft, Daniel Magee, S. Mckenna, D. Millan, Joanne Millar, R. Miller, Ganendra R. Mohan, Sohail Mughal, Sergio Mancini Nicolau, J. Nevin, Abigail S. Oakley, Mary Quigley, Bhavana Rai, Arvind Rajwanshi, Stuart G. Salfinger, Kate Scatchard, Barbara Schmalfeldt, Bryony Simcock, P. Singh, Kyle C. Strickland, Vainta Suri, Sheeba Syed, P. Sykes, Adeline Tan, J. Tan, E. Thompson, Anna V. Tinker, Georgia Trevisan, Maria Gabriela Baumgarten Kuster Uyeda, Michelle M. Vaughan, W. Weichert, Anthony Williams, S. Williams, Naveena Singh

Risultato della ricerca: Contributo in rivistaArticolo in rivista

24 Citazioni (Scopus)

Abstract

Objective: 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. Methods: 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). Results: 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). Conclusions: 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.
Lingua originaleEnglish
pagine (da-a)441-448
Numero di pagine8
RivistaGynecologic Oncology
Volume154
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Antineoplastic Agents
  • Antineoplastic Combined Chemotherapy Protocols
  • Biomarkers, Tumor
  • Carboplatin
  • Chemotherapy response score
  • Disease-Free Survival
  • Fallopian Tube Neoplasms
  • Female
  • High-grade serous tubo-ovarian cancer
  • Humans
  • Neoadjuvant Therapy
  • Neoadjuvant chemotherapy
  • Neoplasms, Cystic, Mucinous, and Serous
  • Ovarian Neoplasms
  • Prognosis
  • Treatment Outcome

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