Dermatomyositis as presenting feature of ovarian cancer, treated with neo-adjuvant chemotherapy and interval debulking surgery

5546 Background: A pre-operative predictive biomarker of CC0 interval debulking surgery (IDS) likelihood would be helpful. The modeled CA125 elimination rate constant KELIM predicts OS in 1st line setting (You et al. Clin Cancer Res 2019). The predictive/prognostic values of KELIM regarding CC scores at IDS, and survivals, during neo-adjuvant chemotherapy were assessed. Methods: The data of the CHIVA randomized phase II trial, comparing carboplatin-paclitaxel +/- nintedanib before IDS (NCT01583322), were used. A semi-mechanistic model was built to describe CA125 longitudinal kinetics during the first 100 treatment days. The relationships between KELIM and IDS CC scores, PFS & OS, were assessed with other major prognostic factors (grade, histology, GCIG CA125 response, FIGO stage, and arm) using multivariate logistic regression (logit), C-index & survival tests. Results: The longitudinal kinetics of 529 CA125 values, assessed every 3 weeks during neo-adj chemotherapy, were modeled in 133 patients (out of 188). KELIM (as a continuous covariate) was the only significant predictive factor of CC0 IDS likelihood using multivariate analyses (OR = 12.37, 95% CI [4.32-39.67]). CC0 IDS probability can be estimated with patient KELIM: ≥ 90 % if standardized KELIM ≥ 0.12. Non-parametric survival models confirmed the independent predictive values of KELIM categorized by terciles regarding PFS & OS (Table). The parametric model linking KELIM (as a continuous covariate) with OS allows to predict the patient survivals (months) based on their estimated KELIM (HR = 0.20, [0.10-0.39]). Conclusions: The prognostic & predictive values of the modeled CA125 KELIM are also confirmed regarding CC0 IDS likelihood, PFS and OS with neo-adjuvant chemotherapy. Patient KELIM is calculable online, based on observed CA125 values, on http://www.biomarker-kinetics.org/ . Clinical trial information: 2011-006288-23. [Table: see text]

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Prognostic factors of overall survival for patients with FIGO stage IIIc or IVa ovarian cancer treated with neo-adjuvant chemotherapy followed by interval debulking surgery: A multicenter cohort analysis from the FRANCOGYN study group

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2020.04.029 ◽

2020 ◽

Vol 46 (9) ◽

pp. 1689-1696

Author(s):

L. Vincent ◽

C. Jankowski ◽

L. Ouldamer ◽

M. Ballester ◽

S. Bendifallah ◽

...

Keyword(s):

Ovarian Cancer ◽

Overall Survival ◽

Cohort Analysis ◽

Figo Stage ◽

Study Group ◽

Debulking Surgery ◽

Stage Iiic ◽

Multicenter Cohort ◽

Interval Debulking Surgery ◽

Neo Adjuvant Chemotherapy

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Quality of life of advanced ovarian cancer patients in the randomized phase III study comparing primary debulking surgery versus neo-adjuvant chemotherapy

Gynecologic Oncology ◽

10.1016/j.ygyno.2013.08.014 ◽

2013 ◽

Vol 131 (2) ◽

pp. 437-444 ◽

Cited By ~ 29

Author(s):

Elfriede Greimel ◽

Gunnar B. Kristensen ◽

Maria E.L. van der Burg ◽

Pluvio Coronado ◽

Gordon Rustin ◽

...

Keyword(s):

Quality Of Life ◽

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Advanced Ovarian Cancer ◽

Phase Iii ◽

Debulking Surgery ◽

Primary Debulking Surgery ◽

Phase Iii Study ◽

Neo Adjuvant Chemotherapy

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Neo-Adjuvant Chemotherapy Reduces, and Surgery Increases Immunosuppression in First-Line Treatment for Ovarian Cancer

Cancers ◽

10.3390/cancers13235899 ◽

2021 ◽

Vol 13 (23) ◽

pp. 5899

Author(s):

Christine De Bruyn ◽

Jolien Ceusters ◽

Chiara Landolfo ◽

Thaïs Baert ◽

Gitte Thirion ◽

...

Keyword(s):

Ovarian Cancer ◽

Adjuvant Chemotherapy ◽

Primary Treatment ◽

Treatment Schedule ◽

Primary Therapy ◽

Immune Microenvironment ◽

Debulking Surgery ◽

Primary Debulking Surgery ◽

Neo Adjuvant Chemotherapy ◽

Related Proteins

In monotherapy, immunotherapy has a poor success rate in ovarian cancer. Upgrading to a successful combinatorial immunotherapy treatment implies knowledge of the immune changes that are induced by chemotherapy and surgery. Methodology: Patients with a new d ovarian cancer diagnosis underwent longitudinal blood samples at different time points during primary treatment. Results.: Ninety patients were included in the study (33% primary debulking surgery (PDS) with adjuvant chemotherapy (ACT), 61% neo-adjuvant chemotherapy (NACT) with interval debulking surgery (IDS), and 6% debulking surgery only). Reductions in immunosuppression were observed after NACT, but surgery reverted this effect. The immune-related proteins showed a pronounced decrease in immune stimulation and immunosuppression when primary treatment was completed. NACT with IDS leads to a transient amelioration of the immune microenvironment compared to PDS with ACT. Conclusion: The implementation of immunotherapy in the primary treatment schedule of ovarian cancer cannot be induced blindly. Carboplatin–paclitaxel seems to ameliorate the hostile immune microenvironment in ovarian cancer, which is less pronounced at the end of primary treatment. This prospective study during primary therapy for ovarian cancer that also looks at the evolution of immune-related proteins provides us with an insight into the temporary windows of opportunity in which to introduce immunotherapy during primary treatment.

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