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Valabrega G, Pothuri B, Oaknin A, Graybill WS, Sánchez AB, McCormick C, Baurain JF, Tinker AV, Denys H, O'Cearbhaill RE, Hietanen S, Moore RG, Knudsen AØ, de La Motte Rouge T, Heitz F, Levy T, York W, Gupta D, Monk BJ, González-Martín A. Efficacy and safety of niraparib in patients aged 65 years and older with advanced ovarian cancer: Results from the PRIMA/ENGOT-OV26/GOG-3012 trial. Gynecol Oncol 2024; 187:128-138. [PMID: 38833992 DOI: 10.1016/j.ygyno.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To evaluate the impact of age on the efficacy and safety of niraparib first-line maintenance therapy in patients with newly diagnosed advanced ovarian cancer with a complete/partial response to first-line platinum-based chemotherapy. METHODS Post hoc analysis of the phase 3 PRIMA/ENGOT-OV26/GOG-3012 study (NCT02655016). Patients in the intent-to-treat population were categorized according to age at baseline (<65 years vs ≥65 years), and progression-free survival (PFS), safety, and health-related quality of life (HRQOL) were evaluated for each age subgroup (clinical cutoff date, May 17, 2019). Safety findings were also evaluated according to a fixed starting dose (FSD) or an individualized starting dose (ISD). RESULTS Of 733 randomized patients, 289 (39.4%) were ≥65 years (190 niraparib, 99 placebo) at baseline. Median PFS (niraparib vs placebo) and hazard ratios (95% CI) were similar in patients aged <65 years (13.9 vs 8.2 months; HR, 0.61 [0.47-0.81]) and ≥65 years (13.7 vs 8.1 months; HR, 0.53 [0.39-0.74]). The incidences of any-grade and grade ≥3 treatment-emergent adverse events (TEAEs) were similar across age subgroups; in the niraparib arm, TEAEs leading to dose discontinuation occurred in 7.8% of patients <65 years and 18.4% of patients ≥65 years. ISD use lowered the incidence of grade ≥3 thrombocytopenia events in niraparib-treated patients compared with the FSD (<65 years: 42.8% vs 18.0%; ≥65 years 57.0% vs 26.1%). HRQOL was comparable across age subgroups. CONCLUSION Niraparib efficacy, safety, and HRQOL were generally comparable across age subgroups, although patients ≥65 years had a higher rate of discontinuations due to TEAEs. ISD use reduced grade ≥3 thrombocytopenia events regardless of age.
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Affiliation(s)
- Giorgio Valabrega
- AO Ordine Mauriziano Torino and Department of Oncology, University of Torino, Torino, Italy.
| | - Bhavana Pothuri
- GOG Foundation and Departments of Obstetrics/Gynecology and Medicine, Division of Gynecologic Oncology, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Ana Oaknin
- Vall d'Hebron University Hospital and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Ana Beatriz Sánchez
- Unit of Genetic Counseling in Cancer and Gynecologic Oncology, Hospital General Universitario de Elche, Elche, Spain
| | | | - Jean-François Baurain
- Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Anna V Tinker
- BC Cancer Vancouver, University of British Columbia, Department of Medicine, Vancouver, BC, Canada
| | - Hannelore Denys
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Roisin E O'Cearbhaill
- Gynecologic Oncology Group (GOG) and Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Sakari Hietanen
- Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
| | - Richard G Moore
- Division of Gynecologic Oncology, Wilmot Cancer Institute, Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | | | | | - Florian Heitz
- AGO Study Group; Department for Gynaecology and Gynaecologic Oncology, Kliniken Essen-Mitte, Essen, Germany; Department of Gynaecology, Charité-Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; and Berlin Institute of Health, Berlin, Germany
| | - Tally Levy
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Tel Aviv Faculty School of Medicine, Tel Aviv University, Holon, Israel
| | | | | | - Bradley J Monk
- Divison of Gynecologic Oncology, HonorHealth Research Institute, University of Arizona, Creighton University, Phoenix, AZ, USA
| | - Antonio González-Martín
- Medical Oncology Department, Cancer Center Clínica Universidad de Navarra, Madrid, Program in Solid Tumours, CIMA, Pamplona, and Grupo Español de Investigación en Cancer ginecológicO (GEICO), Madrid, Spain
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Hirschl N, Leveque W, Granitto J, Sammarco V, Fontillas M, Penson RT. PARP Inhibitors: Strategic Use and Optimal Management in Ovarian Cancer. Cancers (Basel) 2024; 16:932. [PMID: 38473293 DOI: 10.3390/cancers16050932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Poly (ADP-ribose) polymerase (PARP) inhibitors have become an established part of the anticancer armamentarium. Discovered in the 1980s, PARP inhibitors (PARPis) were initially developed to exploit the presence of BRCA mutations, which disrupt the homologous recombination repair of deoxyribonucleic acid (DNA) via synthetic lethality, an intrinsic vulnerability caused by the cell's dependence on other DNA repair mechanisms for which PARP is an essential contributor. PARPi use expanded with the demonstration of clinical benefit when other mechanisms of high-fidelity DNA damage response were present in cancer cells called homologous repair deficiency (HRD). Recently, new data have resulted in the voluntary withdrawal of later-line treatment indications for all the available PARPis used in ovarian cancer because of a negative impact on overall survival (OS). PARPi switch maintenance to consolidate a response to platinum-based therapy is recommended for earlier treatment lines to have the greatest impact on the chance of cure and length of survival. This article reviews the clinical utility of PARPis and how to integrate them into best practices.
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Affiliation(s)
- Nicholas Hirschl
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Wildnese Leveque
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Julia Granitto
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Valia Sammarco
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | | | - Richard T Penson
- Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
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3
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Li Y. Efficacy and safety of PARP inhibitors for maintenance treatment of ovarian cancer, regardless of BRCA or HRD status: a comprehensive updated meta-analysis. J OBSTET GYNAECOL 2023; 43:2171282. [PMID: 36729640 DOI: 10.1080/01443615.2023.2171282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Without taking into account existing biomarkers like genetic mutations (BRCA mutation, Homologous recombination deficiency) with advanced ovarian cancer (OC), the overall survival (OS), progress-free survival (PFS) of the aggregate all groups that have been classified were hazard ratio (HR): 0.72, 95% confidence intervals (CI): 0.66-0.79 and HR: 0.48, 95%CI: 0.44-0.52, respectively. Meanwhile, the OS and PFS of the whole population (regardless of existing genetic mutation markers) were HR: 0.74, 95%CI: 0.64-0.87 and HR: 0.52, 95%CI: 0.42-0.65, separately. Furthermore, the OS and PFS of positive gene mutation markers were HR: 0.71, 95%CI: 0.61-0.83 (HRD and BRACm) and HR: 0.47, 95%CI: 0.42-0.52 (HRD and BRACm), individually. The poly ADP-ribose polymers (PARP) inhibitors have desired efficiency and security in the maintenance treatment of advanced OC patients with BRCAm or BRCAwt, HRD or HRP and unknown gene status.
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Affiliation(s)
- Yanhui Li
- Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, Jinan, China
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4
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Cecere SC, Casartelli C, Forte M, Pignata S, Pisano C. Safety of PARP inhibitors as maintenance therapy in ovarian cancer. Expert Opin Drug Saf 2023; 22:897-908. [PMID: 37668154 DOI: 10.1080/14740338.2023.2254699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/24/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Antiangiogenic agents and poly(ADP-ribose) polymerase inhibitors (PARP-Is) have improved the outcome of patients suffering from ovarian cancer. However, as they are associated with many adverse events (AEs), it is important to be aware of their safety and toxicity profiles. AREAS COVERED We reviewed PARP-I therapeutical indications, mechanism of action, metabolism, and interactions. We reported on all major and minor AEs that have emerged from clinical trials (SOLO1, PRIMA, PAOLA1, ATHENA, SOLO2, NOVA, ARIEL3, NORA), their follow-ups, meta-analyses, and real-world studies, particularly hematologic toxicities and their management, and secondary malignancies (myelodysplastic syndrome and acute myeloid leukemia). We also addressed gastrointestinal, neurological, respiratory, hepatic, and renal toxicity and the use of PARP-Is in older, pregnant, and lactating patients. No specific research strategy in terms of keywords, inclusive dates and databases was used. EXPERT OPINION PARP-Is benefits largely outweigh the risks associated with potential AEs. Randomized controlled trials produced strong good, quality data, but they enrolled a selected population and failed to capture rare events. More pharmacovigilance data and real-life studies on a larger and more heterogeneous sample are needed to understand PARP-Is differences and to clarify the incidence of late AEs to balance the risk/benefit ratio.
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Affiliation(s)
- Sabrina Chiara Cecere
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | | | - Miriam Forte
- Department of Precision Medicine, Division of Medical Oncology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Carmela Pisano
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
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Friedlander M, Lee YC, Tew WP. Managing Adverse Effects Associated With Poly (ADP-ribose) Polymerase Inhibitors in Ovarian Cancer: A Synthesis of Clinical Trial and Real-World Data. Am Soc Clin Oncol Educ Book 2023; 43:e390876. [PMID: 37285556 DOI: 10.1200/edbk_390876] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The use of poly (ADP-ribose) polymerase (PARP) inhibitor therapy is standard care in the management of patients with various malignancies including ovarian, breast, prostate, and pancreatic cancers. PARP inhibitors have been approved in different settings for patients with specific hereditary pathogenic variants, most notably homologous recombination repair pathways such as BRCA1 and BRCA2 genes. The vast experience with PARP inhibitors (olaparib, niraparib, rucaparib) has been in the management of epithelial ovarian cancer. There have not been any head-to-head comparisons of PARP inhibitors in randomized trials, and we can only perform cross-comparison on the basis of the reported literature. The three approved PARP inhibitors share several common adverse effects because of a class effect including nausea, fatigue, and anemia, but there are notable differences likely because of variations in their poly-pharmacology and off-target effects. Finally, patients included in clinical trials are often younger with a good performance status and less comorbidities than the real-world population, and hence, the potential benefits and adverse effects may not be superimposable. In this review, we describe these differences and discuss strategies to mitigate and manage adverse side effects effectively.
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Affiliation(s)
- Michael Friedlander
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Yeh Chen Lee
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Prince of Wales and Royal Hospital for Women, Randwick, New South Wales, Australia
- NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Sabatier R, Rousseau F, Joly F, Cropet C, Montégut C, Frindte J, Cinieri S, Guerra Alía EM, Polterauer S, Yoshida H, Vergote I, Colombo N, Hietanen S, Largillier R, Canzler U, Gratet A, Marmé F, Favier L, Pujade-Lauraine E, Ray-Coquard I. Efficacy and safety of maintenance olaparib and bevacizumab in ovarian cancer patients aged ≥65 years from the PAOLA-1/ENGOT-ov25 trial. Eur J Cancer 2023; 181:42-52. [PMID: 36634389 DOI: 10.1016/j.ejca.2022.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The phase III PAOLA-1/ENGOT-ov25 study (NCT02477644) showed that addition of olaparib to bevacizumab maintenance improved progression-free survival (PFS) in patients with newly diagnosed advanced ovarian cancer. We evaluated maintenance olaparib plus bevacizumab in older patients in PAOLA-1. METHODS Baseline clinical and molecular data, and PFS, were compared between older (aged ≥65 years) and younger patients (<65 years). Factors associated with olaparib efficacy, and safety in age subgroups, were also assessed. RESULTS Of 806 randomised patients, 292 (36.2%) were ≥65 years. A lower proportion of older versus younger patients had an Eastern Cooperative Oncology Group performance status of 0 (61.0% versus 76.2%) and upfront surgery (42.0% versus 55.7%). Older patients were less likely to have a BRCA1/2 mutation (17.1% versus 36.7%) or homologous recombination deficiency-positive status (34.1% versus 55.7%). After median follow-up of 22.1 months, median PFS was 21.6 months with olaparib versus 16.6 months with placebo in the older population (hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.41-0.75), comparable with the younger population (median 22.9 versus 16.9 months; HR 0.61, 95% CI 0.49-0.77). PFS benefits were observed in patients with a BRCA mutation or homologous recombination deficiency-positive tumours. Incidence of olaparib-related grade ≥3 adverse events in older patients was comparable with that of younger patients (36.8% versus 31.7%) although hypertension and anaemia were more common in older patients. No treatment-related deaths occurred in older patients receiving olaparib. CONCLUSION Older patients enrolled in PAOLA-1 achieved similar PFS benefits compared with younger patients, with a similar safety profile.
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Affiliation(s)
- Renaud Sabatier
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM, Aix-Marseille Univ, Inserm, CNRS, Marseille, and GINECO, France.
| | - Frédérique Rousseau
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM, Aix-Marseille Univ, Inserm, CNRS, Marseille, and GINECO, France
| | | | | | - Coline Montégut
- Department of Medical Oncology, Institut Paoli-Calmettes, CRCM, Aix-Marseille Univ, Inserm, CNRS, Marseille, and GINECO, France
| | - Johanna Frindte
- Department of Gynecology & Gynecologic Oncology, Kliniken Essen-Mitte, Essen, and AGO, Germany
| | - Saverio Cinieri
- UOC Oncologia Medica - Ospedale Senatore Antonio Perrino, Brindisi, and MITO, Italy
| | | | - Stephan Polterauer
- Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, and AGO-Austria, Austria
| | | | - Ignace Vergote
- University Hospital Leuven, Leuven Cancer Institute, Leuven, and BGOG, European Union, Belgium
| | - Nicoletta Colombo
- University of Milan-Bicocca and Istituto Europeo di Oncologia, Milan, and MANGO, Italy
| | | | | | - Ulrich Canzler
- Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, and National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, and AGO, Germany
| | | | - Frederik Marmé
- Medical Faculty Mannheim, Heidelberg University, Mannheim, and AGO, Germany
| | - Laure Favier
- Centre Georges François Leclerc, Dijon, and GINECO, France
| | | | - Isabelle Ray-Coquard
- Centre Léon Bérard and University Claude Bernard Lyon 1, Lyon and GINECO, France
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7
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Chelariu-Raicu A, Trillsch F, Burges A, Czogalla B, Hester A, Wuerstlein R, Harbeck N, Mahner S. PARP inhibitors: risk factors for toxicity and matching patients to the proper poly (ADP-ribose) polymerase inhibitor (PARPi) therapy. Int J Gynecol Cancer 2023; 33:812-822. [PMID: 36707086 DOI: 10.1136/ijgc-2022-003990] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The past 5 years have seen several fundamental advances in ovarian cancer, with important new insights towards novel therapeutic opportunities within the DNA repair pathway. With the incorporation of poly (ADP-ribose) polymerase inhibitors (PARPi) into maintenance treatment regimens, the management of short- and long-term adverse events are key clinical priorities. Currently, three different PARPi are clinically beneficial and have been approved for primary and recurrent ovarian cancer: olaparib, niraparib, and rucaparib. The duration of treatment with PARPi in patients with ovarian cancer varies; patients can receive treatment for up to 2 or 3 years in first-line setting, or continue treatment until unacceptable toxicity or progression occurs in recurrent disease. Despite their similar mechanisms of action, these three inhibitors have specific toxicity profiles, which may lead to dose interruptions or discontinuation of treatment. This review summarizes the current indications for PARPi, including their role in recurrent and first-line maintenance treatment for advanced ovarian cancer. We also outline dose modifications leading to treatment disruption and potential changes in quality of life after prolonged treatment. Finally, we highlight the patient groups most likely to benefit from each of the three different PARPi.
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Affiliation(s)
- Anca Chelariu-Raicu
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany .,German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center, Munich, Germany
| | - Fabian Trillsch
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Alexander Burges
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Bastian Czogalla
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Anna Hester
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Rahel Wuerstlein
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, Breast Center, Gynecologic Cancer Center and CCC Munich, Ludwig Maximilians University Munich, Munich, Bayern, Germany.,German Cancer Consortium (DKTK), partner site Munich, German Cancer Research Center, Munich, Germany
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8
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Caruso G, Gigli F, Parma G, Lapresa M, Derio S, Palaia I, Colombo N. Myeloid neoplasms post PARP inhibitors for ovarian cancer. Int J Gynecol Cancer 2023; 33:598-606. [PMID: 36707087 DOI: 10.1136/ijgc-2022-004190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The incidence of myeloid neoplasms following treatment with poly (ADP-ribose) polymerase inhibitors (PARPi) in patients with ovarian cancer has been gradually increasing over the last few years. The cumulative exposure to PARPi and the improved overall survival of patients with ovarian cancer may represent key underlying explanations behind such trend. Fortunately, the earlier introduction of PARPi in the frontline setting reduces the risk of developing secondary myeloid neoplasms. The etiopathogenesis is still unclear but is likely to be multifactorial. The first 2 years of PARPi exposure seem to be the critical window for the onset of myeloid neoplasms post PARPi, with persistent cytopenia recognized as an early warning sign. Despite intensive treatment strategies, the outcome remains poor. There is an unmet clinical need to learn how to minimize risk, make an early diagnosis, and manage myeloid neoplasms post PARPi. First, decision making regarding the optimal maintenance treatment should avoid a 'PARPi-for-all' strategy. PARPi should be used cautiously in cases of high baseline risk for myeloid neoplasms and/or patients who are less likely to have a benefit. Active surveillance, accurate differential diagnosis, and prompt hematological referral are key management pillars. This review discusses what is known on this emerging issue as well as unresolved questions.
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Affiliation(s)
- Giuseppe Caruso
- Department of Maternal and Child Health and Urological Sciences, University of Rome La Sapienza, Rome, Italy .,Gynecologic Oncology Division, European Institute of Oncology, Milan, Italy
| | - Federica Gigli
- Onco-Hematology Division, European Institute of Oncology, Milan, Italy
| | - Gabriella Parma
- Gynecologic Oncology Division, European Institute of Oncology, Milan, Italy
| | | | - Silvia Derio
- Gynecologic Oncology Division, European Institute of Oncology, Milan, Italy
| | - Innocenza Palaia
- Department of Maternal and Child Health and Urological Sciences, University of Rome La Sapienza, Rome, Italy
| | - Nicoletta Colombo
- Medical Gynecologic Oncology Unit, University of Milan Bicocca, European Institute of Oncology, Milan, Italy
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9
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Kraus FBT, Topalov NE, Deuster E, Hysenaj I, Mayr D, Chelariu-Raicu A, Beyer S, Kolben T, Burges A, Mahner S, Trillsch F, Jeschke U, Czogalla B. Expression pattern and prognostic potential of histamine receptors in epithelial ovarian cancer. J Cancer Res Clin Oncol 2022; 149:2501-2511. [PMID: 35751684 PMCID: PMC10129941 DOI: 10.1007/s00432-022-04114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Despite recent advances in the treatment of ovarian cancer (OC), long-term remissions remain scarce. For a targeted approach, prognostic markers are indispensable for predicting survival and treatment response. Given their association with multiple hallmarks of cancer, histamine receptors (HR) are emerging as promising candidates. Here, we investigate their expression pattern and prognostic value in OC. METHODS Specimens of 156 epithelial OC patients were collected during cytoreductive surgery at the Department of Obstetrics and Gynecology, LMU, between 1990 and 2002 and combined in a tissue microarray. Immunohistochemical staining of the HR H1, H2, H3 and H4 was quantified by an immunoreactive score and linked with clinico-pathological data by Spearman's correlation. Via ROC curve analysis, optimal cut-off values for potential prognostic markers were defined. Overall survival (OS) was visualized in Kaplan-Maier curves and significances determined by log-rank testing. A Cox regression model was applied for multivariate analysis. RESULTS HR H3 and H4 expression was restricted to the cytosol of OC cells, while H1 was also present in the nucleus. A significant association between HR H1, H3 and H4 expression with several clinico-pathological parameters was revealed. In addition, HR H1 and H3 expression correlated positively, HR H4 expression negatively with OS. In addition, HR H3 was identified as independent prognostic marker for OS. HR H2 expression had no prognostic value. CONCLUSIONS HR H1, H3 and H4 could serve as potential predictors for OS of OC patients. Further research is warranted to elucidate their pathophysiologic role and their predictive and therapeutic potential in OC.
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Affiliation(s)
- Fabian B T Kraus
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany.
| | - Nicole E Topalov
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - E Deuster
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - I Hysenaj
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - D Mayr
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - A Chelariu-Raicu
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - S Beyer
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - T Kolben
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - A Burges
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - S Mahner
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - F Trillsch
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
| | - U Jeschke
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany.,Department of Obstetrics and Gynecology, University Hospital Augsburg, Augsburg, Germany
| | - B Czogalla
- Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Munich, Germany
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