A Case of Stage III c Ovarian Clear Cell Carcinoma:  The Role for Predictive Biomarkers and Targeted Therapies

Ovarian clear cell carcinoma (OCCC) has been treated with surgery and chemotherapy; however, the prognosis remains poor because of chemoresistance. Therefore, immunotherapies are attracting attention, including the GPC3 peptide vaccine, which improves overall survival. However, the response rate is limited and there are no sufficient predictive biomarkers that can identify responders before treatment. Our purpose was to identify circulating serum miRNAs as predictive biomarkers for response to GPC3 peptide vaccine. Eighty-four patients in a phase II trial of a GPC3 peptide vaccine were enrolled and miRNA sequencing was performed on their serum samples. Candidate miRNAs were selected from a group of 14 patients for whom treatment was responsive and validated in an independent group of 10 patients for whom treatment was responsive. Three markedly upregulated miRNAs, miR-375-3p, miR-193a-5p, and miR-1228-5p, were identified, and the combination of those miRNAs demonstrated high value in the prediction of the response. The origin of these miRNAs was assessed by referring to OCCC tissue miRNA profiles, and they were not identified as cancer tissue-related miRNAs. Functional annotation analysis suggested that they were associated with interferon-related pathways. The miRNAs identified herein have great potential to allow the realization of liquid biopsy for predicting the immunotherapy response and precision medicine.

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Age and Lymph Nodes Examination May Be Related to the Outcome of Ovarian Clear Cell Carcinoma: A SEER Analysis

10.21203/rs.3.rs-864590/v1 ◽

2021 ◽

Author(s):

Menghan Zhu ◽

Nan Jia ◽

Wei Jiang

Keyword(s):

Lymph Nodes ◽

Cell Carcinoma ◽

Proportional Hazards ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Cox Proportional Hazards ◽

Stage I ◽

Stage Iii ◽

Ovarian Clear Cell Carcinoma ◽

Significant Difference

Abstract AimTo analyze and compare the demographics, treatment, and survival rates in patients with ovarian clear cell carcinoma (OCCC).MethodsWe conducted a population-based retrospective study examining the Surveillance, Epidemiology, and End Results Program from 1998 to 2016. Data of 4344 women with OCCC were compared, and survival was analyzed using the Kaplan–Meier method. Factors predictive of outcome were compared using the Cox proportional hazards model.ResultsThere was no significant difference in cause specific survival (CSS) regardless of chemotherapy in stage I and stage II OCCC. In women with stage III/IV OCCC, there was an increased mortality in women without chemotherapy (5-year CSS 29.80% vs. 24.90%, p<0.001). Among stage I women younger than 60 years old, the 5-year CSS of those underwent chemotherapy was worse than that of non-chemotherapy (86.4% vs. 97.50%, p=0.002). Among these patients, omitting chemotherapy had improved CSS (HR 0.539; 95% CI 0.386-0.753), and omitting lymph nodes examination had decreased CSS (HR 1.666; 95% CI 1.230-2.256). In stage III/IV women who were 60 years or older, the 5-year CSS of those underwent chemotherapy was better than that of non-chemotherapy (32.60% vs. 24.30%, p<0.001). Among these patients, omitting chemotherapy (HR 1.769; 95% CI 1.385-2.258) and omitting lymph nodes examination (HR 1.709; 95% CI 1.371-2.130) had lower CSS.ConclusionChemotherapy has different effects in patients with OCCC at different stages and ages. Age and lymph nodes examination may be factors that affect the outcome of patients with OCCC.

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Clinical Characteristics and Prognosis of Ovarian Clear Cell Carcinoma: a Retrospective Study of 112 Patients in Beijing

10.21203/rs.3.rs-132769/v1 ◽

2020 ◽

Author(s):

Huimei Zhou ◽

Qian Liu ◽

Xiaohua Shi ◽

Jiaxin Yang ◽

Dongyan Cao ◽

...

Keyword(s):

Retrospective Study ◽

Cell Carcinoma ◽

Clinical Characteristics ◽

Cox Regression ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Stage I ◽

Stage Iii ◽

Ca 125 ◽

Ovarian Clear Cell Carcinoma

Abstract ObjectivesThis retrospective study aimed to evaluate the clinical characteristics and prognosis of ovarian clear cell carcinoma (OCCC) and to further explore the monitoring value of cancer antigen 125 (CA-125).MethodsThe medical records of 112 OCCC patients who were treated in Peking Union Medical College Hospital (PUMCH) between 2014 and 2019 were collected and reviewed, and data such as age, Federation of Gynecology and Obstetrics (FIGO) stage, CA-125 level, treatment, recurrence, and death were extracted.OutcomesThe median patient age was 50 (45, 57) years. Sixty (53.57%) patients were in stage I, 13 (11.61%) patients were in stage II, 22 (28.57%) patients were in stage III, and 7 (6.25%) patients were in stage IV. In total, 109 (97.32%) patients received adjuvant chemotherapy. The median chemotherapy cycles of CA-125 normalization was 2 (0, 3). The 1-year and 3-year progression-free survival (PFS) rates were 87.85% and 72.90%, respectively. The median PFS1 duration was 19 (11, 35) months, and the median overall survival (OS) duration was 24 (13, 40) months. Recurrence occurred in 32 patients, of whom 7 (21.88%) developed platinum-resistant recurrence. Fifty percent of relapsed patients had a CA-125 level<35 IU/ml at the time of relapse. Nine (28.13%) patients experienced a second recurrence. In the multivariate Cox regression analysis, the Chemotherapy cycles of CA-125 normalization remained nonsignificant for stage I (P=0.003, HR 4.287, 95% CI=1.632–11.258) and stage III (P=0.003, HR 4.287, 95% CI=1.632–11.258) disease. Multivariate Cox regression showed that platinum resistance was an independent factor for PFS2 (P=0.008, HR 11.562, 95% CI=1.873–71.353).ConclusionsFIGO stage and chemotherapy resistance are independent risk factors for prognosis. CA-125 levels following treatment are a valid indicator for treatment monitoring. Regardless of chemosensitivity to CA-125, CA-125 normalization before chemotherapy cycle 2 may not be a distinct inflection point for PFS and OS.

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