scholarly journals The Prognostic and Predictive Role of Somatic BRCA Mutations in Ovarian Cancer: Results from a Multicenter Cohort Study

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 565
Author(s):  
Angela Toss ◽  
Claudia Piombino ◽  
Elena Tenedini ◽  
Alessandra Bologna ◽  
Elisa Gasparini ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Positive Impact ◽  
Progression Free Survival ◽  
Molecular Testing ◽  
Wild Type ◽  
Brca Mutations ◽  
Multicenter Cohort Study ◽  
Advanced Stages ◽  
Predictive Role

Previous research involving epithelial ovarian cancer patients showed that, compared to germline BRCA (gBRCA) mutations, somatic BRCA (sBRCA) mutations present a similar positive impact with regard to overall survival (OS) and platinum and PARP (poly (ADP-ribose) polymerase) inhibitor sensitivity. Nevertheless, molecular testing in these studies did not include copy number variation (CNV) analyses of BRCA genes. The aim of this study was to explore the prognostic and predictive role of sBRCA mutations as compared to gBRCA mutations in patients who were also tested for CNVs. Among the 158 patients included in the study, 17.09% of patients carried a pathogenic or likely pathogenic gBRCA variant and 15.19% of patients presented pathogenetic or likely pathogenic sBRCA variants and/or CNVs. Overall, 81.6% of the patients included in this study were diagnosed with a serous histotype, and 77.2% were in advanced stages. Among women diagnosed in advanced stages, gBRCA patients showed better progression-free survival and OS as compared to sBRCA and wild-type patients, whereas sBRCA patients did not show any advantage in outcome as compared to wild-type patients. In this study, the introduction of CNV analyses increased the detection rate of sBRCA mutations, and the resulting classification among gBRCA, sBRCA and wild-type patients was able to properly stratify the prognosis of OC patients. Particularly, sBRCA mutation patients failed to show any outcome advantage as compared to wild-type patients.

scholarly journals Comparison of Poly (ADP-ribose) Polymerase Inhibitors (PARPis) as Maintenance Therapy for Platinum-Sensitive Ovarian Cancer: Systematic Review and Network Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3026
Author(s):  
Amos Stemmer ◽  
Inbal Shafran ◽  
Salomon M. Stemmer ◽  
Daliah Tsoref
Keyword(s):  
Ovarian Cancer ◽  
Maintenance Therapy ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Wild Type ◽  
Brca Mutations ◽  
Increased Risk ◽  
Significant Difference ◽  
Indirect Comparisons

Background: Three PARPis (olaparib, niraparib and rucaparib) are currently FDA-approved as maintenance therapy in newly diagnosed and recurrent ovarian cancer. However, thus far, no trial has compared the three approved PARPis in the overall population, in patients with BRCA mutations, or in those with wild-type BRCA. Methods: A frequentist network meta-analysis was used for indirect comparisons between the different PARPis with respect to progression free survival (PFS), overall survival (OS), and adverse events. Results: Overall, six randomized clinical trials involving 2,770 patients, were included in the analysis. Results from the indirect comparisons revealed no statistically significant differences between the three PARPis with respect to PFS or OS in the entire population and in patients with mutated and wild-type BRCA, separately. Niraparib showed a statistically significant increased risk for grade 3 and 4 thrombocytopenia (risk-difference [RD] from placebo: 0.3; 95% confidence interval [CI], 0.27‒0.34) and any grade neutropenia (RD from placebo: 0.22; 95% CI, 0.18‒0.25) as compared with the other PARPis. Conclusion: No statistically significant difference was found between the three PARPis with respect to PFS or OS (overall and in subpopulations by BRCA status). There is, however, a statistical difference in toxicity as niraparib is associated with a greater risk for thrombocytopenia and neutropenia.

scholarly journals Germline BRCA, Chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer

2020 ◽  
Author(s):  
Yong Jae Lee ◽  
Hyun-Soo Kim ◽  
John Hoon Rim ◽  
Jung-Yun Lee ◽  
Eun Ji Nam ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Progression Free Survival ◽  
Cancer Center ◽  
Chemotherapy Response ◽  
Wild Type ◽  
Brca Mutations ◽  
Free Survival ◽  
Interval Debulking Surgery

Abstract Background To analyze the effects of BRCA1/2 mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Methods We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline BRCA1/2 test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018. Chemotherapy response scores were compared in patients with and without BRCA1/2 mutations. The effects of BRCA1/2 mutations and CRS on survival were evaluated. Results BRCA1/2 mutations were detected in 47 (28.1%) of the 169 patients. Overall, 16 (34.0%) patients with BRCA1/2 mutations had a CRS 3 to chemotherapy compared to scores of 43 in patients (35.2%) without a mutation. Response scores of 3 in patients with BRCA1/2 mutations were not significantly associated with either improved progression-free survival (PFS) ( P = 0.949) or overall survival (OS) ( P = 0.168). However, CRS 3 in patients without BRCA mutations was significantly associated with both improved PFS ( P = 0.030) and OS ( P = 0.039). In patients with CRS1/2, carriers of BRCA1/2 mutations had better PFS ( P = 0.0344) and OS ( P = 0.043) than wild-type BRCA genotype patients. Conclusion In ovarian cancer patients treated with NAC, CRS did not predict survival for BRCA 1/2 mutation carriers but did for BRCA wild-type patients.

scholarly journals The role of subgroup analyses: results from the NOVA trial

2017 ◽  
Vol 5 (1) ◽  
pp. 40-42
Author(s):  
Massimo Di Maio ◽  
Alice Bergamini
Keyword(s):  
Ovarian Cancer ◽  
Maintenance Treatment ◽  
Progression Free Survival ◽  
Adenosine Diphosphate ◽  
Parp Inhibitors ◽  
Wild Type ◽  
Free Survival ◽  
Platinum Sensitive ◽  
Subgroup Analyses

The clinical efficacy of poly-adenosine diphosphate (ADP) ribose polymerase (PARP) inhibitors in BRCA-mutated ovarian cancer patients has been widely reported. However, novel challenges are currently aimed at broadening the benefit of PARP inhibitors to patients with wild-type BRCA and homologous recombination deficiency (HRD) and identifying a test able to select those patients who might benefit most from this therapy. The recently published ENGOT-OV16/NOVA trial reported an advantage in progression-free survival (PFS) for patients receiving the PARP1/2 inhibitor niraparib, as maintenance treatment for platinum-sensitive ovarian cancer compared to placebo, regardless of their germline BRCA or HRD status. This suggests that niraparib could potentially represent a valuable maintenance option for virtually all patients with platinum-sensitive relapsed ovarian cancer and that the HRD assay used in this trial is not able to reliably identify those patients who benefit the most from niraparib maintenance. These provocative considerations are the result of subgroup analyses that should be interpreted with caution but are useful to show the consistency of the effect of niraparib across the whole population.

scholarly journals Germline BRCA, Chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer

2019 ◽  
Author(s):  
Yong Jae Lee ◽  
Hyun-Soo Kim ◽  
John Hoon Rim ◽  
Jung-Yun Lee ◽  
Eun Ji Nam ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Progression Free Survival ◽  
Cancer Center ◽  
Chemotherapy Response ◽  
Wild Type ◽  
Brca Mutations ◽  
Free Survival ◽  
Interval Debulking Surgery

Abstract Background To analyze the effects of BRCA1/2 mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Methods We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline BRCA1/2 test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018. Chemotherapy response scores were compared in patients with and without BRCA1/2 mutations. The effects of BRCA1/2 mutations and CRS on survival were evaluated. Results BRCA1/2 mutations were detected in 47 (28.1%) of the 169 patients. Overall, 16 (34.0%) patients with BRCA1/2 mutations had a CRS 3 to chemotherapy compared to scores of 43 in patients (35.2%) without a mutation. Response scores of 3 in patients with BRCA1/2 mutations were not significantly associated with either improved progression-free survival (PFS) ( P = 0.949) or overall survival (OS) ( P = 0.168). However, CRS 3 in patients without BRCA mutations was significantly associated with both improved PFS ( P = 0.030) and OS ( P = 0.039). In patients with CRS1/2, carriers of BRCA1/2 mutations had better PFS ( P = 0.0344) and OS ( P = 0.043) than wild-type BRCA genotype patients. Conclusion In ovarian cancer patients treated with NAC, CRS did not predict survival for BRCA 1/2 mutation carriers but did for BRCA wild-type patients.

scholarly journals Germline BRCA, Chemotherapy response scores, and survival in the neoadjuvant treatment of ovarian cancer

2020 ◽  
Author(s):  
Yong Jae Lee ◽  
Hyun-Soo Kim ◽  
John Hoon Rim ◽  
Jung-Yun Lee ◽  
Eun Ji Nam ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Neoadjuvant Treatment ◽  
Progression Free Survival ◽  
Cancer Center ◽  
Chemotherapy Response ◽  
Wild Type ◽  
Brca Mutations ◽  
Free Survival ◽  
Interval Debulking Surgery

Abstract Background To analyze the effects of BRCA1/2 mutations on chemotherapy response scores (CRS) and survival in a cohort of patients with advanced-stage ovarian cancer who were treated with neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Methods We retrospectively reviewed the medical records of 169 high-grade serous ovarian cancer patients who underwent a germline BRCA1/2 test and received three cycles of NAC at the Yonsei Cancer Center from 2006 to 2018. Chemotherapy response scores were compared in patients with and without BRCA1/2 mutations. The effects of BRCA1/2 mutations and CRS on survival were evaluated. Results BRCA1/2 mutations were detected in 47 (28.1%) of the 169 patients. Overall, 16 (34.0%) patients with BRCA1/2 mutations had a CRS 3 to chemotherapy compared to scores of 43 in patients (35.2%) without a mutation. Response scores of 3 in patients with BRCA1/2 mutations were not significantly associated with either improved progression-free survival (PFS) ( P = 0.949) or overall survival (OS) ( P = 0.168). However, CRS 3 in patients without BRCA mutations was significantly associated with both improved PFS ( P = 0.030) and OS ( P = 0.039). In patients with CRS1/2, carriers of BRCA1/2 mutations had better PFS ( P = 0.0344) and OS ( P = 0.043) than wild-type BRCA genotype patients. Conclusion In ovarian cancer patients treated with NAC, CRS did not predict survival for BRCA 1/2 mutation carriers but did for BRCA wild-type patients.

The Role of Surgery in IDH-Wild-Type Lower-Grade Gliomas: Threshold at a High Extent of Resection Should be Pursued

Neurosurgery ◽  
2021 ◽  
Author(s):  
Peng Wang ◽  
Chen Luo ◽  
Peng-jie Hong ◽  
Wen-ting Rui ◽  
Shuai Wu
Keyword(s):  
Cox Regression ◽  
Progression Free Survival ◽  
Extent Of Resection ◽  
Lower Grade ◽  
Wild Type ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Lower Grade Glioma ◽  
Clinical Benefits

Abstract BACKGROUND While maximizing extent of resection (EOR) is associated with longer survival in lower-grade glioma (LGG) patients, the number of cases remains insufficient in determining a EOR threshold to elucidate the clinical benefits, especially in IDH-wild-type LGG patients. OBJECTIVE To identify the effects of EOR on the survival outcomes of IDH-wild-type LGG patients. METHODS IDH-wild-type LGG patients were retrospectively reviewed. The effect of EOR and other predictor variables on overall survival (OS) and progression-free survival (PFS) was analyzed using Cox regression models and the Kaplan-Meier method. RESULTS A total of 94 patients (median OS: 48.9 mo; median follow-up: 30.6 mo) were included in this study. In the multivariable Cox regression analysis, postoperative residual volume was associated with prolonged OS (HR = 2.238; 95% confidence interval [CI], 1.130-4.435; P = .021) and PFS (HR = 2.075; 95% CI, 1.113-3.869; P = .022). Thresholds at a minimum EOR of 97.0% or a maximum residue of 3.0 cm3 were necessary to impact OS positively. For the telomerase reverse transcriptase (TERT)p-wild-type group, such an association was absent. Significant differences in survival existed between the TERTp-wild-type and mutant patients who underwent relatively incomplete resections (residual ≥2.0 cm3 + TERTp wild type: median OS of 62.6 mo [95% CI: 39.7-85.5 mo]; residual ≥2.0 cm3 + TERTp mutant: median OS of 20.0 mo [95% CI:14.6-25.4 mo]). CONCLUSION Our results support the core role of maximal safe resection in the treatment of IDH-wild-type LGGs, especially for IDH-wild-type + TERTp-mutant LGGs. Importantly, the survival benefits of surgery could only be elucidated at a high EOR cut-off point.

scholarly journals Spatial, Temporal, and Functional Assessment of LC3-Dependent Autophagy inShigella flexneriDissemination

2018 ◽  
Vol 86 (8) ◽  
Author(s):  
Erin Weddle ◽  
Hervé Agaisse
Keyword(s):  
Colonic Mucosa ◽  
Defense Mechanism ◽  
Positive Impact ◽  
Shigella Flexneri ◽  
Wild Type ◽  
Content Type ◽  
Cell Defense ◽  
Membrane Protrusions ◽  
Cell Spread

ABSTRACTShigella flexneridisseminates within the colonic mucosa by displaying actin-based motility in the cytosol of epithelial cells. Motile bacteria form membrane protrusions that project into adjacent cells and resolve into double-membrane vacuoles (DMVs) from which the bacteria escape, thereby achieving cell-to-cell spread. During dissemination,S. flexneriis targeted by LC3-dependent autophagy, a host cell defense mechanism against intracellular pathogens. TheS. flexneritype III secretion system effector protein IcsB was initially proposed to counteract the recruitment of the LC3-dependent autophagy machinery to cytosolic bacteria. However, a recent study proposed that LC3 was recruited to bacteria in DMVs formed during cell-to-cell spread. To resolve the controversy and clarify the role of autophagy inS. flexneriinfection, we tracked dissemination using live confocal microscopy and determined the spatial and temporal recruitment of LC3 to bacteria. This approach demonstrated that (i) LC3 was exclusively recruited to wild-type oricsBbacteria located in DMVs and (ii) theicsBmutant was defective in cell-to-cell spread due to failure to escape LC3-positive as well as LC3-negative DMVs. Failure ofS. flexnerito escape DMVs correlated with late LC3 recruitment, suggesting that LC3 recruitment is the consequence and not the cause of DMV escape failure. Inhibition of autophagy had no positive impact on the spreading of wild-type oricsBmutant bacteria. Our results unambiguously demonstrate that IcsB is required for DMV escape during cell-to-cell spread, regardless of LC3 recruitment, and do not support the previously proposed notion that autophagy countersS. flexneridissemination.

Predictive role of biology in the feasibility of optimal versus suboptimal cytoreduction in advanced serous ovarian cancer

2013 ◽  
Vol 130 (1) ◽  
pp. e9
Author(s):  
R. Abdallah ◽  
N. Bou Zgheib ◽  
I. Ramirez-Diaz ◽  
S. Apte ◽  
P. Judson Lancaster ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Serous Ovarian Cancer ◽  
Predictive Role
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