PLATINUM SENSITIVITY IS ASSOCIATED WITH DISTINCT GENE SIGNATURES AND BIOLOGICAL FUNCTIONAL PATHWAYS IN EPITHELIAL OVARIAN CANCER

Author(s):  
June Hou
2020 ◽  
Author(s):  
Yan Rong ◽  
Li Li

Abstract Objectives: To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitivity and prognosis in patients with ovarian cancer.Method: HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.Results: 16 patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. When HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p<0.0001, p<0.0001) as well as CA125 after 1st cycle chemotherapy (p<0.0001, p<0.0001).Conclusions: Our data suggested that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitivity and risk to progress and relapse.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17072-e17072 ◽  
Author(s):  
Sarah Todd ◽  
Sharon E. Robertson ◽  
Yin Xiong ◽  
Martine Extermann ◽  
Robert Michael Wenham ◽  
...  

e17072 Background: This study aimed to assess the impact of clinical factors, including age and comorbidity, and treatment on outcomes data for women 70 years and older with advanced epithelial ovarian cancer (EOC). Methods: A retrospective chart review was performed on 501 patients with advanced EOC cancer at a single institution between January 1, 2001 and April 1, 2014. Exclusion criteria included non-epithelial histology, stage less than IIIC, and incomplete medical records. Clinical data included disease characteristics, performance measures (ECOG Performance Score, Karnofsky Performance Status, Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score), method of treatment and outcome (surgical debulking status, Mayo Surgical Complexity Score, use of intraperitoneal (IP) chemotherapy, total lines of therapy), and survival data. Results: One hundred twenty-six study subjects (25.15%) were > 70 years old at the time of advanced EOC diagnosis. In a univariate analysis, study subjects > 70 years old were significantly more likely to have a higher CIRS-G score, fewer total lines of therapy, no IP therapy, less enrollment in clinical trials, decreased platinum sensitivity, and worse progression free survival (PFS) and overall survival (OS). A multivariate logistic regression analysis, using variables significant to a level of p < 0.1 in the univariate analysis, demonstrated that patients > 70 years old were significantly more likely to have a higher CIRS-G score (OR1.14, p = 0.00037), worse OS (OR0.98, p = 0.00026), and less likely to have IP therapy (OR0.57, p = 0.04973). Factors independently associated with decreased OS in all study subjects in a multivariate cox proportion hazard model were fewer total lines of therapy (HR0.24, p = 0.0035), lack of IP therapy (HR0.64, p = 0.0036), suboptimal debulking status (HR1.38, p = 0.045), lack of platinum sensitivity (HR0.30, p = 0.00001), and older age (HR1.62, p = 0.0016). Conclusions: In this cohort of patients with advanced EOC, elderly patients had worsened OS. This appears to correlate with comorbidity, lack of platinum sensitivity, along with less aggressive treatment options, number of lines of therapy, IP chemotherapy, and clinical trial enrollments.


2020 ◽  
Author(s):  
Yan Rong ◽  
Li Li

Abstract Objectives: To assess the clinical value of early clearance of HE4 and CA125 for platinum sensitive and prognosis in patients with ovarian cancerMethod: HE4 and CA125 value including clinical data of 89 patients with ovarian cancer were collected. The clearance of HE4 and CA125 were assessed base on the platinum sensitivity, two-year PFS, PFS and OS.Results: 16 patients were classified as platinum resistant and 73 as platinum sensitive according to the response to platinum-base chemotherapy. when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle chemotherapy, it gave the highest AUC of 0.788, with 100% of sensitivity and 57.5% of specificity respectively between platinum resistant and platinum sensitive group. In addition, 59 patients were classified as two-year PFS group and 30 as not achieved two-year PFS group according to obtaining two-year PFS or not. It gave the highest AUC of 0.730, with 83.3% of sensitivity and 62.7% of specificity respectively when HE4 clearance after 3rd cycle chemotherapy or CA125 clearance after 1st cycle. The prolonged PFS and OS were significantly associated by the clearance of HE4 after 3rd cycle chemotherapy (p < 0.0001, p < 0.0001) as well as CA125 after 1st cycle chemotherapy (p < 0.0001, p < 0.0001).Conclusions: Our data suggest that the early clearance of HE4 and CA125 could predict platinum response and prognosis in patients with ovarian cancer. Monitoring the HE4 and CA125 during first-line chemotherapy might be helpful in predicting platinum sensitive and risk to progress and relapse.


2018 ◽  
Vol 15 (3) ◽  
pp. 177-181 ◽  
Author(s):  
İlker Kahramanoğlu ◽  
Nedim Tokgözoğlu ◽  
Hasan Turan ◽  
Veysel Şal ◽  
Gönül Şimşek ◽  
...  

2006 ◽  
Vol 16 (Suppl 1) ◽  
pp. 68-73 ◽  
Author(s):  
J. Dupont ◽  
C. Aghajanian ◽  
G. Andrea ◽  
M. Lovegren ◽  
S. Chuai ◽  
...  

A variety of agents have emerged to treat patients with recurrent epithelial ovarian cancer (EOC). Most patients receive both topotecan (T) and liposomal doxorubicin (D); however, there are no data regarding the benefit of a sequence—D followed by T (DT) or T followed by D (TD). We identified 89 consecutive patients with recurrent EOC, who received both D and T from January 1994 to January 2004 at Memorial Hospital. We compared the duration of treatment, toxicity, and overall survival (OS) for patients who received either DT or TD. Sixty-four patients received DT, and 25 patients received TD. The groups were balanced regarding age, stage, surgical debulking, platinum sensitivity, prior therapy, and intervening drugs between D and T. Median numbers of cycles on DT and TD were seven and six, respectively (P= 0.61); there was no difference in duration based on platinum sensitivity. Removal from therapy for toxicity was similar, DT (22%) and TD (36%) (P= 0.18). Finally, there was no difference in median OS based on sequence, DT (18.28 months) and TD (17.75 months) (P= NS). Platinum sensitivity did not affect median OS based on sequence. Based on duration, toxicity, and OS there is no advantage of one sequence of D and T when treating patients with recurrent EOC.


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