Potential role of MAD1 1673G>A and ERCC1 8092C>A polymorphisms in the resistance to chemotherapy in advanced ovarian cancer: A pilot study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17045-e17045
Author(s):  
Irwin Alejandro Hernandez Cruz ◽  
Diddier Prada ◽  
José Díaz-Chávez ◽  
Salim Barquet-Munoz ◽  
David Francisco Cantu De Leon ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pilot Study ◽  
Gynecological Cancer ◽  
Advanced Ovarian Cancer ◽  
Rank Test ◽  
Log Rank Test ◽  
Response To Chemotherapy ◽  
Chi Squared ◽  
Resistance To Chemotherapy

e17045 Background: Ovarian cancer (OC) is the most lethal gynecological cancer and 70% of cases are in advanced stages at diagnosis. The standard treatment for those stages is optimal cytoreduction plus chemotherapy based on carboplatin-paclitaxel. Nevertheless, 60%-70% of patients will progress after diagnosis, becoming resistant in some point of the disease. There are no biomarkers to predict response to chemotherapy in OC. Some polymorphisms, including MAD1 1673G > A and ERCC1 8092C > A have shown potential to predict chemoresistance in other tumors. Thus, we explored the role of these polymorphisms in the resistance to chemotherapy in advanced OC. Methods: We genotypified 89 OC patients samples, and also determined the mRNA expression for both genes by RT-PCR. We compared distributions using chi-squared test and determined differences in overall survival and free-relapse survival using Kaplan-Meier curves and log-rank test. Results: Most of cases were IIIC stage (35.48%), papillary histological subtype (32.26%), highly differentiated (67.74%), and 35.48% tumors with recurrence. Distribution for MAD1 genotype was 35.48% for wild-type (WT), 32.26% for heterozygous (HT), and 32.26% for homozygous polymorphic condition (Poly). For ERCC1, we found a distribution of 25.81% for WT, 51.61% for HT, and 22.58% for Poly. When comparing distributions, we found statistically significant differences between sensitive vs. resistant tumors ( p= 0.02), with lack of the WT condition for ERCC1 in sensitive tumors. When analyzing haplotypes in regard to platinum-sensitivity, we also found statistical differences in the distribution of haplotypes ( p = 0.02). No association between genotypes and expression was observed. Remarkably, we found a lower free-relapse survival in the presence of at least one WT allele for the MAD1 polymorphism (p = 0.021, log-rank test). Conclusions: In this pilot study, we have found that ERCC1 8092C > A polymorphism, as well as haplotypes for these two genes, could be associated with chemoresistance. MAD1 1673G > A polymorphism could play also a role in recurrence in advanced OC.

Does aggressive surgery only benefit patients with less advanced ovarian cancer?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5556-5556
Author(s):  
Shinichi Tate ◽  
Kyoko Nishikimi ◽  
Ayumu Matsuoka ◽  
Satoyo Otsuka ◽  
Makio Shozu
Keyword(s):  
Ovarian Cancer ◽  
Advanced Ovarian Cancer ◽  
Wilcoxon Test ◽  
Rank Test ◽  
Survival Outcomes ◽  
Debulking Surgery ◽  
Perioperative Morbidity ◽  
Log Rank Test ◽  
Surgery Group ◽  
Intergroup Comparison

5556 Background: The recent SCORPION trial showed that aggressive primary debulking surgery (PDS) did not improve survival outcomes in patients with advanced ovarian cancer and was associated with a high incidence of perioperative morbidity. We compared survival outcomes and morbidity between patients who underwent highly aggressive and less aggressive surgery at our hospital; patients with high tumor loads were treated with neoadjuvant chemotherapy (NACT), followed by aggressive surgery. Methods: This retrospective study included 209 patients with a surgical complexity score (SCS) ≥8, who underwent aggressive surgery between January 2008 and December 2018. PDS, followed by chemotherapy was performed in this study, and NACT followed by interval debulking surgery (IDS) was performed in patients with excessively high tumor loads, a poor general condition, or unresectable lesions in whom PDS was contraindicated. Based on the median SCS, patients were categorized into highly aggressive surgery and less aggressive surgery groups, and we performed an intergroup comparison of progression-free survival (PFS), overall survival (OS), and perioperative morbidity. Results: The median SCS was 13 in all cohorts. The less aggressive surgery group (SCS < 13) and the highly aggressive surgery group (SCS≥13) included 83 and 126 patients, respectively. The peritoneal cancer index in the highly aggressive surgery group was higher than that in the less aggressive surgery group (20 vs. 9). Notably, 52 patients (63%) underwent PDS in the less aggressive surgery group, and 104 patients (83%) underwent IDS after NACT in the highly aggressive surgery group. No intergroup difference was observed in patients without any residual disease (less aggressive surgery group: 74 patients [89%] vs. highly aggressive surgery group: 118 patients [94%], p = 0.245). The median PFS in the less- and highly aggressive surgery groups was 32 months (95% confidence interval [CI] 24–45) and 31 months (95% CI 27–34) (log-rank test, p = 0.622; Wilcoxon test, p = 0.926), respectively. The median OS in the less- and highly aggressive surgery groups was 99 months (95% CI 59–not reached) and 75 months (95% CI 56–106) (log-rank test, p = 0.390; Wilcoxon test, p = 0.799), respectively. Severe perioperative complications (Clavien-Dindo grade ≥IIIb) occurred in 4 patients (4.8%) and 8 patients (6.4%) in the less- and highly aggressive surgery groups, respectively (p = 0.767). Conclusions: Aggressive surgery benefits both patients with less advanced and advanced ovarian cancer. Selection of the optimal timing of debulking surgery may lead to better survival outcomes without an increase in perioperative morbidity in patients with high tumor loads, who undergo highly aggressive surgery.

Role of laparoscopy to assess the chance of optimal cytoreductive surgery in advanced ovarian cancer: a pilot study

2005 ◽  
Vol 96 (3) ◽  
pp. 729-735 ◽  
Author(s):  
Anna Fagotti ◽  
Francesco Fanfani ◽  
Manuela Ludovisi ◽  
Roberto Lo Voi ◽  
Giuseppe Bifulco ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pilot Study ◽  
Cytoreductive Surgery ◽  
Advanced Ovarian Cancer

Potential Role of Lymphadenectomy in Advanced Ovarian Cancer: A Combined Exploratory Analysis of Three Prospectively Randomized Phase III Multicenter Trials

2010 ◽  
Vol 28 (10) ◽  
pp. 1733-1739 ◽  
Author(s):  
Andreas du Bois ◽  
Alexander Reuss ◽  
Philipp Harter ◽  
Eric Pujade-Lauraine ◽  
Isabelle Ray-Coquard ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Residual Disease ◽  
Survival Rates ◽  
Advanced Ovarian Cancer ◽  
Exploratory Analysis ◽  
Phase Iii ◽  
Rank Test ◽  
Primary Surgery ◽  
The Impact

Purpose Primary surgery followed by platinum/taxane-based chemotherapy is the standard therapy in advanced ovarian cancer. The prognostic role of complete debulking has been well described; however, the impact of systematic pelvic and para-aortic lymphadenectomy and its interaction with biologic factors are still not fully defined. Methods This was an exploratory analysis of three prospective randomized trials (Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom trials 3, 5, and 7) investigating platinum/taxane-based chemotherapy regimens in advanced ovarian cancer conducted between 1995 and 2002. Results One thousand nine hundred twenty-four patients were analyzed. Lymphadenectomy was associated with superior survival in patients without gross residual disease. In patients with and without lymphadenectomy, the median survival time was 103 and 84 months, respectively, and 5-year survival rates were 67.% and 59.2%, respectively (P = .0166); multivariate analysis confirmed a significant impact of lymphadenectomy on overall survival (OS; hazard ratio [HR] = 0.74; 95% CI, 0.59 to 0.94; P = .0123). In patients with small residual tumors up to 1 cm, the effect of lymphadenectomy on OS barely reached significance (HR = 0.85; 95% CI, 0.72 to 1.00; P = .0497). For patients with small residual tumors and clinically suspect nodes, lymphadenectomy resulted in a 16% gain in 5-year OS (log-rank test, P = .0038). Conclusion Lymphadenectomy in advanced ovarian cancer might offer benefit mainly to patients with complete intraperitoneal debulking. However, this hypothesis should be confirmed in the context of a prospectively randomized trial.

scholarly journals Evaluation of a Simple and Safe Tumor Drilling Technique to Potentiate the Effect of Intraperitoneal Chemotherapy in the Treatment of Recurrent Epithelial Ovarian, Tubal, and Peritoneal Cancer: A Matched Retrospective Cohort Study

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986377
Author(s):  
Wei-Ting Chao ◽  
Ching-Hui Chien ◽  
Chung-Ru Lai ◽  
Hui-Ju Wu ◽  
Chi-Mu Chuang
Keyword(s):  
Ovarian Cancer ◽  
Retrospective Cohort ◽  
Comparison Group ◽  
Group Versus ◽  
Rank Test ◽  
Second Line ◽  
Cohort Group ◽  
Log Rank Test ◽  
Drilling Technique

Frontline intraperitoneal chemotherapy (IPCT) in the treatment of epithelial ovarian cancer has been well established. However, the role of second-line IPCT is yet to be confirmed. With a view to implementing IPCT to treat recurrent disease, a prerequisite is to perform a cytoreductive procedure to minimize residual tumor size. However, the role of cytoreductive procedure is still in debate due to a higher chance of complications. A matched retrospective cohort study was conducted. From 2008 to 2015, we adopted a relatively simple and safe tumor drilling technique to maximize tumor exposure to second-line IPCT. Patients who received tumor drilling followed by second-line IPCT constituted the cohort group. Concurrently, patients who received standard second-line systemic chemotherapy were selected as the comparison group. After propensity score matching, 85 patients in each group entered into the final analysis. The median progression-free survival was 7.3 months (95% confidence interval [CI], 6.2-7.8) for the cohort group versus 4.1 months (95% CI, 4.0-4.3) for the comparison group (hazard ratio = 0.25 [95% CI, 0.17-0.36]; P < .001, by log-rank test). The median overall survival was 33.6 months (32.1-36.6) for the cohort group versus 25.9 months (20.5-26.9) for the comparison group (hazard ratio = 0.33 [95% CI, 0.23-0.48]; P < .001, by log-rank test). Toxicities in the cohort group were not different from those that were published in reports of IPCT for ovarian cancer. The most commonly observed toxicity was gastrointestinal origin (51.7%), and it may be attributed to the intraperitoneal pharmacokinetic clearance of cisplatin and taxol and we also discussed the mechanism of gastrointestinal toxicity. Tumor drilling followed by second-line IPCT may confer a survival advantage over standard second-line systemic chemotherapy in the treatment of recurrent ovarian cancer.

The role of CT, PET-CT, and MRI in ovarian cancer

2021 ◽  
Vol 94 (1125) ◽  
pp. 20210117
Author(s):  
Maurits Peter Engbersen ◽  
Willemien Van Driel ◽  
Doenja Lambregts ◽  
Max Lahaye
Keyword(s):  
Ovarian Cancer ◽  
Essential Role ◽  
Advanced Ovarian Cancer ◽  
Emission Tomography ◽  
Current Position ◽  
Positron Emission ◽  
Pet Ct ◽  
New Treatment ◽  
Ct And Mri

New treatment developments in ovarian cancer have led to a renewed interest in staging advanced ovarian cancer. The treatment of females with ovarian cancer patients has a strong multidisciplinary character with an essential role for the radiologist. This review aims to provide an overview of the current position of CT, positron emission tomography-CT, and MRI in ovarian cancer and how imaging can be used to guide multidisciplinary team discussions.

scholarly journals A radiologic-laparoscopic model to predict suboptimal (or complete and optimal) debulking surgery in advanced ovarian cancer: a pilot study

2019 ◽  
Vol Volume 11 ◽  
pp. 333-342 ◽  
Author(s):  
Antoni Llueca ◽  
Anna Serra ◽  
Katty Delgado ◽  
Karina Maiocchi ◽  
Rosa Jativa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pilot Study ◽  
Advanced Ovarian Cancer ◽  
Debulking Surgery ◽  
Optimal Debulking

Carboplatin (JM 8), Adriamycin and Cyclophosphamide (JAC) in Advanced Ovarian Carcinoma: A Pilot Study

1988 ◽  
Vol 74 (2) ◽  
pp. 217-220 ◽  
Author(s):  
Pier Franco Conte ◽  
Milena Bruzzone ◽  
Silvana Chiara ◽  
Riccardo Rosso ◽  
Giuseppe Giaccone ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Pilot Study ◽  
Ovarian Carcinoma ◽  
Dose Level ◽  
Combination Treatment ◽  
Renal Toxicity ◽  
Advanced Ovarian Cancer ◽  
Hematologic Toxicity ◽  
Advanced Ovarian Carcinoma ◽  
Dose Limiting Toxicity

Eleven untreated patients with advanced ovarian cancer were studied for tolerance and response to combination treatment with fixed doses of adriamycin (45 mg/m2) and cyclophosphamide (600 mg/m2) + escalating doses of carboplatin. At the first dose level of carboplatin (200 mg/m2), toxicity was acceptable. With carboplatin at 300 mg/m2, severe hematologic toxicity was observed. The dose-limiting toxicity was leukopenia. Although carboplatin was administered without any hydration, no patient experienced renal toxicity. Eight objective responses were observed in 9 clinically evaluable patients. At second look surgery, 3 complete responses and 4 partial responses were documented. Polychemotherapy with JAC (carboplatin, 200 mg/m2, adriamycin, 45 mg/m2, and cyclophosphamide, 600 mg/m2) is administrable with acceptable toxicity.

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