1
|
Han L, Song T, Wang X, Luo Y, Gu C, Li X, Wen J, Wen Z, Shi X. miR-21 Responsive Nanocarrier Targeting Ovarian Cancer Cells. Comput Struct Biotechnol J 2024; 24:196-204. [PMID: 38495121 PMCID: PMC10940798 DOI: 10.1016/j.csbj.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
In recent years, DNA origami-based nanocarriers have been extensively utilized for efficient cancer therapy. However, developing a nanocarrier capable of effectively protecting cargos such as RNA remains a challenge. In this study, we designed a compact and controllable DNA tubular origami (DTO) measuring 120 nm in length and 18 nm in width. The DTO exhibited appropriate structural characteristics for encapsulating and safeguarding cargo. Inside the DTO, we incorporated 20 connecting points to facilitate the delivery of cargoes to various ovarian and normal epithelial cell lines. Specifically, fluorescent-labeled DNA strands were attached to these sites as cargoes. The DTO was engineered to open upon encountering miR-21 through RNA/DNA strand displacement. Significantly, for the first time, we inhibited fluorescence using the compact DNA nanotube and observed dynamic fluorescent signals, indicating the controllable opening of DTO through live-cell imaging. Our results demonstrated that the DTO remained properly closed, exhibited effective internalization in ovarian cancer cells in vitro, showcasing marked differential expression of miR-21, and efficiently opened with short-term exposure to miR-21. Leveraging its autonomous behavior and compact design, the DTO emerges as a promising nanocarrier for various clinically relevant materials. It holds significant application prospects in anti-cancer therapy and the development of flexible biosensors.
Collapse
Affiliation(s)
- Liting Han
- Department of Gynecology 2, Renmin Hospital of Wuhan University, Wuhan, China
| | - Tao Song
- College of Computer Science and Technology, China University of Petroleum (East China), Qingdao, China
| | - Xinyu Wang
- Department of Gynecology 2, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Luo
- Department of Gynecology 2, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chuanqi Gu
- Department of Gynecology 2, Renmin Hospital of Wuhan University, Wuhan, China
- College of Computer Science and Technology, China University of Petroleum (East China), Qingdao, China
- Institute of Computing Science and Technology, Guangzhou University, Guangzhou, China
| | - Xin Li
- Department of Gynecology 2, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinda Wen
- Institute of Computing Science and Technology, Guangzhou University, Guangzhou, China
| | - Zhibin Wen
- Institute of Computing Science and Technology, Guangzhou University, Guangzhou, China
| | - Xiaolong Shi
- Institute of Computing Science and Technology, Guangzhou University, Guangzhou, China
| |
Collapse
|
2
|
Miras I, Estévez-García P, Muñoz-Galván S. Clinical and molecular features of platinum resistance in ovarian cancer. Crit Rev Oncol Hematol 2024; 201:104434. [PMID: 38960218 DOI: 10.1016/j.critrevonc.2024.104434] [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: 02/27/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/05/2024] Open
Abstract
Ovarian cancer is the most lethal of all the gynecological tumors despite remarkable advances in our understanding of its molecular biology. The cornerstone treatment remains cytoreductive surgery followed by platinum-based chemotherapy. Recently, the addition of targeted therapies, such as PARP inhibitors, as first-line maintenance has led to outstanding improvements, mainly in BRCA mutated and homologous recombination deficient tumors. However, a significant proportion of patients will experience recurrence, primarily due to platinum resistance, which ultimately result in fatality. Among these patients, primary platinum-resistant have a particularly dismal prognosis due to their low response to current available therapies, historical exclusion from clinical trials, and the absence of validated biomarkers. In this review, we discuss the concept of platinum resistance in ovarian cancer, the clinical and molecular characteristics of this resistance, and the current and new treatment options for these patients.
Collapse
Affiliation(s)
- Isabel Miras
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Consejo Superior de Investigaciones Científicas, Seville, Spain; Medical Oncology Department. Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Purificación Estévez-García
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Consejo Superior de Investigaciones Científicas, Seville, Spain; Medical Oncology Department. Hospital Universitario Virgen del Rocío, Seville, Spain; CIBER de CANCER, Institute of Health Carlos III, Madrid, Spain
| | - Sandra Muñoz-Galván
- Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Consejo Superior de Investigaciones Científicas, Seville, Spain; CIBER de CANCER, Institute of Health Carlos III, Madrid, Spain.
| |
Collapse
|
3
|
Chase DM, Shukla S, Moore J, Boyle TAC, Lim J, Perhanidis J, Hurteau JA, Schilder JM. Patient Characteristics Associated with Time to Next Treatment in Patients with Ovarian Cancer Treated with Niraparib: The PRED1CT Real-World Study. Oncol Ther 2024; 12:599-607. [PMID: 39097531 PMCID: PMC11333773 DOI: 10.1007/s40487-024-00294-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 07/16/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION Niraparib first-line maintenance (1LM) therapy has demonstrated clinical benefit for patients with ovarian cancer (OC) in clinical trial and real-world settings, but data on factors associated with real-world patient outcomes remain limited. This analysis identified patient characteristics associated with time to next treatment (TTNT), a proxy for real-world progression-free survival, in patients with OC treated with 1LM niraparib monotherapy. METHODS This retrospective observational study used a USA nationwide electronic health record-derived deidentified database and included adult patients diagnosed with OC who initiated 1LM niraparib monotherapy after first-line platinum-based chemotherapy. Patients were followed until the earliest occurrence of last clinical activity, death, or end of study period. TTNT was measured from 1LM niraparib initiation to the start of second-line treatment or death. Cox proportional hazards models assessed univariable and multivariable associations between baseline characteristics and TTNT. RESULTS Of 7872 patients diagnosed with OC, 526 met the eligibility criteria and were included in this analysis. Median (IQR) duration of follow-up was 14.1 (7.4-23.6) months. In univariable analyses, age, BRCA/homologous recombination deficiency (HRD) status, socioeconomic status, stage at initial diagnosis, cytoreductive surgery type, and residual disease status were significantly associated with observed TTNT and were introduced into the multivariable model with other clinically relevant variables. In the multivariable analysis, BRCA/HRD status, cytoreductive surgery type, and residual disease status were significantly associated with observed TTNT after covariate adjustment. Conversely, age, Eastern Cooperative Oncology Group performance status, disease stage, niraparib starting dose status, and first-line bevacizumab use were not associated with observed TTNT. CONCLUSION This real-world, retrospective, observational analysis offers valuable insights on prognostic factors associated with TTNT in patients with OC treated with 1LM niraparib monotherapy after first-line platinum-based chemotherapy. Future studies are needed to examine how additional patient characteristics associated with clinical outcomes may guide treatment decisions and improve outcomes.
Collapse
Affiliation(s)
- Dana M Chase
- David Geffen School of Medicine at UCLA, 855 Tiverton Dr, Los Angeles, CA, 90024, USA.
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Rimel B, Boyle TAC, Burns S, Lim J, Hartman J, Kalilani L, Schilder JM, Hurteau JA, Golembesky A. Real-World First-Line Maintenance Niraparib Monotherapy Use Following Chemotherapy Plus Bevacizumab: The SW1TCH Study. Oncol Ther 2024; 12:465-475. [PMID: 38965204 PMCID: PMC11333408 DOI: 10.1007/s40487-024-00281-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/09/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Clinical trials have demonstrated prolonged survival associated with niraparib first-line maintenance (1LM) therapy, compared with placebo, for patients with ovarian cancer (OC). However, data are limited on real-world 1LM niraparib monotherapy use, particularly as switch 1LM, following first-line (1L) combination chemotherapy plus bevacizumab. This real-world study aimed to describe patient demographics, clinical characteristics, and clinical outcomes of patients with OC receiving 1LM niraparib monotherapy following 1L combination chemotherapy plus bevacizumab. METHODS This retrospective observational study used data from a US-based nationwide database of deidentified, electronic health record-derived data. Patients diagnosed with OC during the study period (1 January 2011-30 November 2022, inclusive) were eligible if they received 1L chemotherapy plus bevacizumab treatment followed by 1LM niraparib monotherapy, initiated between 1 January 2017 (inclusive) and 2 September 2022. Patients were followed from index date (initiation of niraparib 1LM) until the first occurrence of death, end of follow-up, or end of study. Clinical outcomes were time to treatment discontinuation (TTD) and time to next treatment (TTNT). Kaplan-Meier curves were used to estimate TTD, TTNT, and 95% confidence intervals (CIs). RESULTS Among 93 patients selected, median age at index was 67 years (interquartile range [IQR] 60-72 years). Most patients had BRCA wild-type/homologous recombination (HR)-proficient or BRCA wild-type/HR unknown disease (75.3%). In all, 18 (19.4%) patients had HR-deficient disease. Five (5.4%) patients had unknown test results for both BRCA and HR deficiency status. Median follow-up time was 16.3 months (IQR 8.7-25.4 months), and median time from end of 1L therapy to 1LM initiation was 35.0 days (IQR 25.0-53.9 days). Median TTD was 9.3 months (95% CI 6.1-11.3 months). Median TTNT was 12.9 months (95% CI 11.5-19.0 months). CONCLUSIONS This real-world study provided insights into switch maintenance with 1LM niraparib monotherapy, which may be a viable treatment option for patients with advanced OC.
Collapse
Affiliation(s)
- Bobbie Rimel
- Cedars-Sinai Medical Center, 8700 Beverly Blvd, Suite 290W, Los Angeles, CA, 90048, USA.
| | | | - Sara Burns
- GSK, 1000 Winter St, Waltham, MA, 02451, USA
| | - Jonathan Lim
- GSK, 1250 S Collegeville Rd, Upper Providence, PA, 19426, USA
| | - John Hartman
- GSK, 2929 Walnut St, Philadelphia, PA, 19104, USA
| | | | | | | | | |
Collapse
|
5
|
Shen HH, Hong YR, Xu W, Chen L, Chen JM, Yang ZG, Chen CH. Nomogram predicting the prognosis of primary liver cancer after radiofrequency ablation combined with transcatheter arterial chemoembolization. World J Gastrointest Surg 2024; 16:2630-2639. [DOI: 10.4240/wjgs.v16.i8.2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/22/2024] [Accepted: 07/11/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The incidence and mortality rates of primary hepatocellular carcinoma (HCC) are high, and the conventional treatment is radiofrequency ablation (RFA) with transcatheter arterial chemoembolization (TACE); however, the 3-year survival rate is still low. Further, there are no visual methods to effectively predict their prognosis.
AIM To explore the factors influencing the prognosis of HCC after RFA and TACE and develop a nomogram prediction model.
METHODS Clinical and follow-up information of 150 patients with HCC treated using RFA and TACE in the Hangzhou Linping Hospital of Traditional Chinese Medicine from May 2020 to December 2022 was retrospectively collected and recorded. We examined their prognostic factors using multivariate logistic regression and created a nomogram prognosis prediction model using the R software (version 4.1.2). Internal verification was performed using the bootstrapping technique. The prognostic efficacy of the nomogram prediction model was evaluated using the concordance index (CI), calibration curve, and receiver operating characteristic curve.
RESULTS Of the 150 patients treated with RFA and TACE, 92 (61.33%) developed recurrence and metastasis. Logistic regression analysis identified six variables, and a predictive model was created. The internal validation results of the model showed a CI of 0.882. The correction curve trend of the prognosis prediction model was always near the diagonal, and the mean absolute error before and after internal validation was 0.021. The area under the curve of the prediction model after internal verification was 0.882 [95% confidence interval (95%CI): 0.820-0.945], with a specificity of 0.828 and sensitivity of 0.656. According to the Hosmer-Lemeshow test, χ2 = 3.552 and P = 0.895. The predictive model demonstrated a satisfactory calibration, and the decision curve analysis demonstrated its clinical applicability.
CONCLUSION The prognosis of patients with HCC after RFA and TACE is affected by several factors. The developed prediction model based on the influencing parameters shows a good prognosis predictive efficacy.
Collapse
Affiliation(s)
- Hai-Hua Shen
- Department of Ultrasound, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China
| | - Yu-Rong Hong
- Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Wen Xu
- Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
| | - Lei Chen
- Department of Ultrasound, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China
| | - Jun-Min Chen
- Department of Ultrasound, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China
| | - Zhi-Gen Yang
- Department of Ultrasound, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China
| | - Cai-Hong Chen
- Department of Nursing, Hangzhou Linping Hospital of Traditional Chinese Medicine, Hangzhou 311106, Zhejiang Province, China
| |
Collapse
|
6
|
Vledder A, Paijens ST, Loiero D, Maagdenberg A, Duiker EW, Bart J, Hendriks AM, Jalving M, Werner N, van Rooij N, Plat A, Wisman GBA, Yigit R, Roelofsen T, Kruse AJ, de Lange NM, Koelzer VH, de Bruyn M, Nijman HW. B cells critical for outcome in high grade serous ovarian carcinoma. Int J Cancer 2024. [PMID: 39175107 DOI: 10.1002/ijc.35149] [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: 12/20/2023] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 08/24/2024]
Abstract
Recent work has shown evidence for the prognostic significance of tumor infiltrating B cells (B-TIL) in high grade serous ovarian carcinoma (HGSOC), the predominant histological subtype of ovarian cancer. However, it remains unknown how the favorable prognosis associated with B-TIL relates to the current standard treatments of primary debulking surgery (PDS) followed by chemotherapy or (neo-)adjuvant chemotherapy (NACT) combined with interval debulking surgery. To address this, we analyzed the prognostic impact of B-TIL in relationship to primary treatment and tumor infiltrating T cell status in a highly homogenous cohort of HGSOC patients. This analysis involved a combined approach utilizing histological data and high-dimensional flow cytometry analysis. Our findings indicate that while HGSOC tumors pre-treated with NACT are infiltrated with tumor-reactive CD8+ and CD4+ TIL subsets, only B-TIL and IgA plasma blasts confer prognostic benefit in terms of overall survival. Importantly, the prognostic value of B-TIL and IgA plasma blasts was not restricted to patients treated with NACT, but was also evident in patients treated with PDS. Together, our data point to a critical prognostic role for B-TIL in HGSOC patients independent of T cell status, suggesting that alternative treatment approaches focused on the activation of B cells should be explored for HGSOC.
Collapse
Affiliation(s)
- Annegé Vledder
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sterre T Paijens
- Department of Radiotherapy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Dominik Loiero
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zürich, Switzerland
| | - Alexis Maagdenberg
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Evelien W Duiker
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joost Bart
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Anne M Hendriks
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mathilde Jalving
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Naomi Werner
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nienke van Rooij
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annechien Plat
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - G Bea A Wisman
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Refika Yigit
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thijs Roelofsen
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arnold J Kruse
- Department of Obstetrics and Gynecology, Isala Hospital Zwolle, Zwolle, The Netherlands
| | - Nastascha M de Lange
- Department of Obstetrics and Gynecology, Isala Hospital Zwolle, Zwolle, The Netherlands
| | - Viktor H Koelzer
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zürich, Switzerland
| | - Marco de Bruyn
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hans W Nijman
- Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
7
|
Woll SM, Lee MW, Neuman MK, Pino C, Klar M, Roman LD, Wright JD, Matsuo K. Stage IC grade 1 endometrioid adenocarcinoma of the ovary: assessment of post-operative chemotherapy de-escalation. Int J Gynecol Cancer 2024:ijgc-2024-005718. [PMID: 39160085 DOI: 10.1136/ijgc-2024-005718] [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: 08/21/2024] Open
Abstract
OBJECTIVE Given limited real-world practice data evaluating the National Comprehensive Cancer Network clinical practice guidelines for possible post-operative chemotherapy omission as a treatment option for patients with stage IC grade 1 endometrioid ovarian carcinoma, this population-based study examined the association between post-operative chemotherapy and overall survival in this tumor group. METHODS The National Cancer Institute's Surveillance, Epidemiology, and End Results program was retrospectively queried. The study population was 1207 patients with stage IC grade 1-3 endometrioid ovarian carcinoma who received primary cancer-directed surgery from 2007 to 2020. Overall survival was assessed with multivariable Cox proportional hazard regression model. RESULTS The median age was 52, 54, and 55 years for grade 1, 2, and 3 groups, respectively (p=0.02). Grade 1 and 2 tumors were more common than grade 3 tumors (n=508 (42.1%), n=493 (40.8%), and n=206 (17.1%), respectively). Chemotherapy use rate for grade 1 tumors was lower compared with grade 2-3 tumors (67.9%, 76.5%, and 78.6%, respectively, p<0.001). When nodal evaluation was performed for grade 1 tumors, among patients who did not receive post-operative chemotherapy and among those who did, 5-year overall survival rate exceeded 90% (93.3% and 96.0%, respectively), with statistically non-significant hazard estimates (adjusted hazard ratio (aHR) 1.54, 95% CI 0.63 to 3.73). In contrast, post-operative chemotherapy omission for patients who did not undergo nodal evaluation was associated with decreased overall survival (5-year rates 82.3% vs 96.0%, aHR 5.41, 95% CI 1.95 to 15.06). Results were similar for node-evaluated grade 2 tumors (5-year overall survival rates, 94.6% and 94.4% for node-evaluated post-operative chemotherapy omission and administration, respectively), but not in grade 3 tumors. CONCLUSION The results of this population-based study may partially support the current clinical practice guidelines for post-operative chemotherapy omission as a possible option for patients with stage IC grade 1 endometrioid adenocarcinoma of the ovary for those who had lymph node evaluation. Observed data were also supportive for node-evaluated grade 2 tumors, warranting further evaluation.
Collapse
Affiliation(s)
- Sabrina M Woll
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
- Keck School of Medicine University of Southern California, Los Angeles, California, USA
| | - Matthew W Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | - Monica K Neuman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | - Christian Pino
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | - Maximilian Klar
- Department of Obstetrics and Gynecology, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Lynda D Roman
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
8
|
Jain AJ, Schultz K, Brainerd MJ, Murimwa GZ, Fleming AM, Fackche N, Bilir E, Chiba A, Martin AN, Singh P, Childers CP, Freidman LR, Zafar N, Abdelsattar Z, Cortina C, Stewart C, Cowher MD, Ganai S, Merck B, Nandakumar G, Pandalai PK, Narayan RR, Ahmad SA. The Top Ten Annals of Surgical Oncology Original Articles on Twitter/X: 2020-2023. Ann Surg Oncol 2024:10.1245/s10434-024-15936-z. [PMID: 39138773 DOI: 10.1245/s10434-024-15936-z] [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: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 08/15/2024]
Abstract
Social media has become omnipresent in society, especially given that it enables the rapid and widespread communication of news, events, and information. Social media platforms have become increasingly used by numerous surgical societies to promote meetings and surgical journals to increase the visibility of published content. In September 2020, Annals of Surgical Oncology (ASO) established its Social Media Committee (SMC), which has worked to steadily increase the visibility of published content on social media platforms, namely X (formerly known as Twitter). The purpose of this review is to highlight the 10 ASO original articles with the most engagement on X, based on total number of mentions, since the founding of the SMC. These articles encompass a wide variety of topics from various oncologic disciplines including hepatopancreatobiliary, breast, and gynecologic surgery.
Collapse
Affiliation(s)
- Anish J Jain
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
| | - Kurt Schultz
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Micah J Brainerd
- Department of Surgery, Cleveland Clinic Akron General, Akron, OH, USA
| | - Gilbert Z Murimwa
- Department of Surgery, University of Texas Southwestern, Dallas, TX, USA
| | - Andrew M Fleming
- Department of Surgery, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nadege Fackche
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Esra Bilir
- Department of Gynecologic Oncology, Koc University School of Medicine, Istanbul, Turkey
- Department of Obstetrics and Gynecology, Die Klinik in Preetz, Preetz, Germany
| | - Akiko Chiba
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Allison N Martin
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Puneet Singh
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christopher P Childers
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lindsay R Freidman
- Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nabeel Zafar
- Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Zaid Abdelsattar
- Division of Thoracic Surgery, Stritch School of Medicine, Chicago, IL, USA
| | - Chandler Cortina
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Camille Stewart
- Division of Surgical Oncology, CommonSpirit Associated Surgeons St. Anthony, Lakewood, CO, USA
| | - Michael D Cowher
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sabha Ganai
- Department of Surgery, University of North Dakota, Grand Forks, ND, USA
| | - Belen Merck
- Departamento de Cirugía, Universidad Cardenal Herrera CEU, Alfara del Patriarca, Valencia, Spain
| | | | - Prakash K Pandalai
- Department of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Raja R Narayan
- Division of Surgical Oncology, Department of Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Syed A Ahmad
- Division of Surgical Oncology, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| |
Collapse
|
9
|
Tan L, Ni Y, Huang Z, Yan J, Wu M, Zhang Z, Zhang F, Wang Z. Efficacy and safety of VEGFR inhibitors for recurrent ovarian cancer: a systematic review. Future Oncol 2024:1-19. [PMID: 39129672 DOI: 10.1080/14796694.2024.2373680] [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: 11/17/2023] [Accepted: 05/31/2024] [Indexed: 08/13/2024] Open
Abstract
Aim: Vascular endothelial growth factor receptor inhibitors (VEGFRIs) have been common used for recurrent ovarian cancer (ROC), but insufficient high-level evidence on verifying its efficacy and safety. Methods: Randomized controlled trials (RCTs) were searched under eight electronic databases. Stata 14.0 and Review Manager 5.3 were used for data analysis. Certainty of the evidence was assessed using the GRADE profiler. This systematic review (SR) was registered under INPLASY (INPLASY202120019). Conclusion: Totally 23 RCTs involving 2810 patients were included in this SR. Current evidence revealed that VEGFRIs had better efficacy, survival and quality of life in the treatment of ROC. Though VEGFRIs increase some drug-related adverse events (AEs), all the AEs could be manageable in the clinical practice.
Collapse
Affiliation(s)
- Linlin Tan
- Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000,China
- Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, 510000, China
| | - Yuchun Ni
- Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000,China
| | - Zhaowei Huang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 200120, China
| | - Jiaqi Yan
- Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000,China
| | - Mei Wu
- Shanxi University of Chinese Medicine, Taiyuan, Shanxi Province, 030000, China
| | - Zhipeng Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, 200120, China
| | - Fupeng Zhang
- Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000,China
- Shanghai University of Traditional Chinese Medicine, Shanghai, 200120, China
| | - Zhijie Wang
- Shanxi Hospital of Traditional Chinese Medicine,Taiyuan,Shanxi Province,030000,China
| |
Collapse
|
10
|
Liu L, Zou C, Shen J, Huang R, Zhang F, Du Y, Luo X, Yang A, Zhang J, Guan Y, Yan X. MUL1 identified as mitochondria-linked biomarker promoting cisplatin resistance in OC cells. Gene 2024; 930:148841. [PMID: 39134101 DOI: 10.1016/j.gene.2024.148841] [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: 12/13/2023] [Revised: 07/22/2024] [Accepted: 08/09/2024] [Indexed: 08/17/2024]
Abstract
Ovarian cancer (OC) ranks among the prevalent tumors affecting the female reproductive system. The aim of this study was to evaluate mitochondria-associated platinum resistance genes using organoid models. Univariate Cox regression, LASSO and multivariate Cox regression analyses were performed on The Cancer Genome Atlas (TCGA) database to construct 2-gene prognostic signature (MUL1 and SSBP1), and GSE26712 dataset was used for external validation. In addition, the relationship between MUL1 and platinum resistance was examined by organoid culture, lentiviral transduction, CCK8 assay, and Western blot. The results showed that patients in the high-risk group exhibited significantly worse OS (P = 0.002, P = 0.017). Drug sensitivity analysis revealed that platinum resistance increased with the upregulation of MUL1 expression (Cor = 0.5154, P = 0.02). Our experimental findings demonstrated that knockout of the MUL1 gene significantly increased apoptosis and enhanced the sensitivity of the OC cell line A2780 to cisplatin. Through this study, we have provided strong evidence for further research on prognostic risk factors and individualized treatment in OC patients, and provided new insights into addressing platinum resistance in OC.
Collapse
Affiliation(s)
- Lixiao Liu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
| | - Chengyang Zou
- The Affiliated Central Hospital of Lishui, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui 323000, China.
| | - Jingtian Shen
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Rong Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Fubin Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
| | - Yongming Du
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
| | - Xishao Luo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Aiwu Yang
- Department of Obstetrics and Gynecology, The Wenzhou People's Hospital, Wenzhou, Zhejiang, China.
| | - Jinsan Zhang
- Department of Medical Research Center and the Department of Pulmonary Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Yutao Guan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
| | - Xiaojian Yan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
11
|
Vilches JC, Santía MC, Yates EM, Pareja R, Lozano M, Ramirez PT. Notable surgical trials in gynecologic oncology: a 10-year overview. Int J Gynecol Cancer 2024; 34:1273-1282. [PMID: 38858104 DOI: 10.1136/ijgc-2024-005471] [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] [Indexed: 06/12/2024] Open
Abstract
In the last decade, we have witnessed important advances in novel therapeutics in the management of gynecologic cancers. These studies have built on the findings from preexisting data and have provided incremental contributions leading to changes that have not only impacted the accuracy of cancer detection and its metastatic components but also led to improvements in oncologic outcomes and quality of life. Key landmark trials have changed the standard of care in cervix, uterine, and ovarian cancer. A number of these have been controversial and have generated significant debate among gynecologic oncologists. The main objective of this review was to provide an overview on each of these trials as a reference for immediate and consolidated access to the study aims, methodology, results, and conclusion.
Collapse
Affiliation(s)
- José C Vilches
- Department of Obstetrics and Gynecology, Hospital Quironsalud Malaga, Malaga, Spain
| | - María Clara Santía
- Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas, USA
| | - Elise Mann Yates
- Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas, USA
| | - Rene Pareja
- Gynecology, Gynecologic Oncology, Clinica ASTORGA, Medellin, and Instituto Nacional de Cancerología, Medellin, Colombia
| | - Manuel Lozano
- Department of Obstetrics and Gynecology, Hospital Quironsalud Malaga, Malaga, Spain
| | - Pedro T Ramirez
- Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas, USA
| |
Collapse
|
12
|
Attianese D, Massobrio R, Giorgi M, Villa M, Fuso L, Badellino E, Bellero M, Ferrero A. Real-life clinical benefit of oral metronomic cyclophosphamide administration in elderly and heavily pretreated epithelial ovarian cancer patients. Arch Gynecol Obstet 2024:10.1007/s00404-024-07670-4. [PMID: 39093333 DOI: 10.1007/s00404-024-07670-4] [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: 03/20/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Oral metronomic cyclophosphamide (OMC) implicates the daily administration of low doses of chemotherapy. Its antitumor activity combined with an oral administration route and a good toxicity profile makes OMC an attractive option for heavily pretreated patients. We retrospectively evaluated OMC's clinical benefit and objective response in recurrent ovarian cancer patients. METHODS This is a retrospective observational study involving patients treated with OMC (50 mg daily) from 2017 to 2022 at the Academic Division Gynaecology, Mauriziano Hospital, Torino, Italy. Clinical benefit assessment included CA125 response, radiological response, and reported symptomatic improvement. Toxicities were reported using Common Terminology Criteria for Adverse Events version 5.0. RESULTS Thirty-eight patients (average age 72, range 49-88) were included. 90% had FIGO stage III/IV at diagnosis and 64% underwent ≥ 3 previous lines of chemotherapy. Before OMC, 79% had ECOG 1 or 2. 8.6% of patients had a partial response (PR), and 40% a stable disease (SD). Median duration of response was 7.4 months. After 3 months on OMC, 51% experienced symptom improvement, and 53.3% experienced Ca125 reduction or stabilization. 66.7% of patients older than 75 responded to treatment; in 40% of cases, responses lasted ≥ 6 months (p = 0.08). No G3-4 hematological toxicities occurred. Nausea and fatigue G1-G2 were reported in 5 (13%) and 13 (34%) cases, respectively. CONCLUSION OMC is a feasible therapeutic option for recurrent ovarian cancer, providing satisfying clinical responses with a good toxicity profile, even in elderly and heavily pretreated patients with a suboptimal performance status.
Collapse
Affiliation(s)
- Daniela Attianese
- Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy
| | - Roberta Massobrio
- Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy
| | - Margherita Giorgi
- Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy
| | - Michela Villa
- Division of Gynecology and Obstetrics, Cardinal Massaia Hospital, Asti, Italy
| | - Luca Fuso
- Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy
| | - Enrico Badellino
- Division of Gynecology and Obstetrics, Cardinal Massaia Hospital, Asti, Italy
| | - Marco Bellero
- Pharmacology Division of Mauriziano Umberto I Hospital, Torino, Italy
| | - Annamaria Ferrero
- Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy.
- Department of Surgical Sciences, University of Torino, Torino, Italy.
| |
Collapse
|
13
|
Ruytenberg T, Ciggaar IA, Peters ITA, Noortman WA, Dibbets-Schneider P, de Muynck LDAN, Kuil J, de Kroon CD, Molenaar TJM, Helmerhorst HJF, Pereira Arias-Bouda LM, Vahrmeijer AL, Windhorst AD, van Velden FHP, Gaarenstroom KN, de Geus-Oei LF. Challenges in Pharmacokinetic Modelling of [ 18F]fluoro-PEG-folate PET/CT Imaging in Epithelial Ovarian Cancer Patients. Mol Imaging Biol 2024; 26:577-584. [PMID: 38775919 PMCID: PMC11282117 DOI: 10.1007/s11307-024-01922-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/25/2024] [Accepted: 05/02/2024] [Indexed: 07/28/2024]
Abstract
PURPOSE To describe the pharmacokinetic properties of the [18F]fluoro-polyethylene glycol(PEG)-folate radiotracer in PET/CT imaging of patients with advanced stage epithelial ovarian cancer (EOC). PROCEDURES In five patients with advanced EOC (FIGO stage IIIB/IIIC, Fédération Internationale de Gynécologie et d'Obstétrique), a 90-min dynamic PET acquisition of the pelvis was performed directly after i.v. administration of 185 MBq [18F]fluoro-PEG6-folate. Arterial blood samples collected at nineteen timepoints were used to determine the plasma input function. A static volume of interest (VOI) for included tumor lesions was drawn manually on the PET images. Modelling was performed using PMOD software. Three different models (a 1-tissue compartment model (1T2k) and two 2-tissue compartment models, irreversible (2T3k) and reversible (2T4k)) were compared in goodness of fit with the time activity curves by means of the Akaike information criterion. RESULTS The pharmacokinetic analysis in the pelvic area has proven to be much more challenging than expected. Only four out of 22 tumor lesions in five patients were considered suitable to perform modelling on. The remaining tumor lesions were inapt due to either low tracer uptake, small size, proximity to other [18F]fluoro-PEG6-folate -avid structures and/or displacement by abdominal organ motion in the dynamic scan. Data from the four analyzed tumor lesions suggest that the irreversible 2T3k may best describe the pharmacokinetics. All 22 lesions were immunohistochemically stained positive for the folate receptor alpha (FRα) after resection. CONCLUSION Performing pharmacokinetic analysis in the abdominal pelvic region is very challenging. This brief article describes the challenges and pitfalls in pharmacokinetic analysis of a tracer with high physiological accumulation in the intestines, in case of lesions of limited size in the abdominal pelvic area.
Collapse
Affiliation(s)
- Thomas Ruytenberg
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Isabeau A Ciggaar
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Inge T A Peters
- Dept. Of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wyanne A Noortman
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Petra Dibbets-Schneider
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Joeri Kuil
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelis D de Kroon
- Dept. Of Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom J M Molenaar
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Hendrik J F Helmerhorst
- Dept. of Anesthesiology and Intensive Care, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Albert D Windhorst
- Dept. of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, The Netherlands
| | - Floris H P van Velden
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Lioe-Fee de Geus-Oei
- Dept. of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands.
| |
Collapse
|
14
|
Rajadevan N, Flinkier A, Saunders H, Lee YC, Scott C, Khaw P, Allan P, Davies C, Andrews J, Wilson M, Lombard JM, Harrison M, Nesfield H, DeFazio A, Meniawy T, Gorringe KL. Mucinous ovarian carcinoma: A survey of practice in Australia and New Zealand. Aust N Z J Obstet Gynaecol 2024; 64:319-325. [PMID: 38299485 DOI: 10.1111/ajo.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/06/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Mucinous ovarian carcinoma (MOC) is a rare ovarian cancer with limited evidence to support clinical care. AIMS We undertook a clinician survey to better understand current practice in treating MOC in Australia and New Zealand, and to determine any features associated with variation in care. In addition, we aimed to understand future research priorities. METHODS A RedCap survey was distributed to clinician members of the Australia New Zealand Gynaecological Oncology Group (ANZGOG). Questions included respondent demographics, three case studies and future research priorities. Clinicians were asked questions specific to their speciality. RESULTS Respondents (n = 47) were commonly experienced gynae-oncology specialists, most often surgical (38%) or medical (30%) oncologists. There was good consensus for surgical approaches for stage I disease; however, variation in practice was noted for advanced or recurrent MOC. Variation was also observed for medical oncologists; in early-stage disease there was no clear consensus on whether to offer chemotherapy, or which regimen to recommend. For advanced and recurrent disease a wide range of chemotherapy options was considered, with a trend away from an ovarian-type toward gastrointestinal (GI)-type regimens in advanced MOC. This practice was reflected in future research priorities, with 'Is a GI chemotherapy regimen better than an ovarian regimen?' the most highly ranked option, followed by 'Should stage 1C patients receive chemotherapy?' CONCLUSIONS Although the number of respondents limited the analyses, it was clear that chemotherapy selection was a key point of divergence for medical oncologists. Future research is needed to establish well-evidenced guidelines for clinical care of MOC.
Collapse
Affiliation(s)
- Niveditha Rajadevan
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Ariane Flinkier
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Hugo Saunders
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Yeh Chen Lee
- Prince of Wales Hospital and Royal Hospital for Women, Sydney, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Clare Scott
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Pearly Khaw
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Prue Allan
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Claire Davies
- Australia New Zealand Gynaecological Oncology Group, Sydney, New South Wales, Australia
| | - John Andrews
- Australia New Zealand Gynaecological Oncology Group, Sydney, New South Wales, Australia
| | - Michelle Wilson
- Auckland City Hospital and The University of Auckland, Auckland, New Zealand
| | | | | | - Heshani Nesfield
- Australia New Zealand Gynaecological Oncology Group, Sydney, New South Wales, Australia
| | - Anna DeFazio
- The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
- The Westmead Institute for Medical Research, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Tarek Meniawy
- St John of God Hospital and University of Western Australia, Perth, Western Australia, Australia
| | - Kylie L Gorringe
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| |
Collapse
|
15
|
Murris F, Weyl A, Ouldamer L, Lorenzini J, Delvallee J, Martinez A, Ferron G, Chollet C, De Barros A, Chantalat E. Contribution of the cadaveric recirculation system in the anatomical study of lymphatic drainage of the ovary: applications in the management of ovarian cancer. Surg Radiol Anat 2024; 46:1155-1164. [PMID: 38900203 DOI: 10.1007/s00276-024-03406-w] [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: 03/11/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE The present knowledge about lymphatic drainage of the ovary is based on carcinological studies, but it has only rarely been studied under physiological conditions. However, it is one of the preferential routes of dissemination in ovarian cancer, and understanding it is therefore vital for optimal carcinological management.Our purpose was to evaluate the feasibility of an innovative technique to study the lymphatic drainage territories of the ovary using a recirculation module on the cadaveric model. METHODS We injected patent blue into the cortex of twenty "revascularised" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary. RESULTS We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%. CONCLUSION Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer.
Collapse
Affiliation(s)
- Floriane Murris
- Département de chirurgie gynécologique, Chu Bretonneau Tours, Tours, 37000, France.
| | - Ariane Weyl
- Département de chirurgie gynécologique chu Rangueil Toulouse et laboratoire d'anatomie chu Rangueil Toulouse, Toulouse, 31000, France
| | - Lobna Ouldamer
- Département de chirurgie gynécologique, Chu Bretonneau Tours, Tours, 37000, France
| | | | - Julie Delvallee
- Département de chirurgie gynécologique, Chu Bretonneau Tours, Tours, 37000, France
| | - Alejandra Martinez
- Département de chirurgie gynécologique, IUCT Oncopole, Toulouse, 31000, France
| | - Gwenael Ferron
- Département de chirurgie gynécologique, IUCT Oncopole, Toulouse, 31000, France
| | - Charlotte Chollet
- Département de chirurgie gynécologique, IUCT Oncopole, Toulouse, 31000, France
| | - Amaury De Barros
- Département de neurochirurgie chu Pierre Paul Riquet Toulouse et laboratoire d'anatomie chu Toulouse, Toulouse, 31000, France
| | - Elodie Chantalat
- Département de chirurgie gynécologique chu Rangueil Toulouse et laboratoire d'anatomie chu Rangueil Toulouse, Toulouse, 31000, France
| |
Collapse
|
16
|
Marolt N, Pavlič R, Kreft T, Gjogorska M, Rižner TL. Targeting estrogen metabolism in high-grade serous ovarian cancer shows promise to overcome platinum resistance. Biomed Pharmacother 2024; 177:117069. [PMID: 38968802 DOI: 10.1016/j.biopha.2024.117069] [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: 05/15/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/07/2024] Open
Abstract
The high mortality rate due to chemoresistance in patients with high-grade ovarian cancer (HGSOC) emphasizes the urgent need to determine optimal treatment strategies for advanced and recurrent cases. Our study investigates the interplay between estrogens and chemoresistance in HGSOC and shows clear differences between platinum-sensitive and -resistant tumors. Through comprehensive transcriptome analyzes, we uncover differences in the expression of genes of estrogen biosynthesis, metabolism, transport and action underlying platinum resistance in different tissues of HGSOC subtypes and in six HGSOC cell lines. Furthermore, we identify genes involved in estrogen biosynthesis and metabolism as prognostic biomarkers for HGSOC. Additionally, our study elucidates different patterns of estrogen formation/metabolism and their effects on cell proliferation between six HGSOC cell lines with different platinum sensitivity. These results emphasize the dynamic interplay between estrogens and HGSOC chemoresistance. In particular, targeting the activity of steroid sulfatase (STS) proves to be a promising therapeutic approach with potential efficacy in limiting estrogen-driven cell proliferation. Our study reveals potential prognostic markers as well as identifies novel therapeutic targets that show promise for overcoming resistance and improving treatment outcomes in HGSOC.
Collapse
Affiliation(s)
- Nika Marolt
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Renata Pavlič
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Tinkara Kreft
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Marija Gjogorska
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Tea Lanišnik Rižner
- Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia.
| |
Collapse
|
17
|
van den Berg CB, Dasgupta S, Ewing-Graham PC, Bart J, Bulten J, Gaarenstroom KN, de Hullu JA, Mom CH, Mourits MJE, Steenbeek MP, van Marion R, van Beekhuizen HJ. Does serous tubal intraepithelial carcinoma (STIC) metastasize? The clonal relationship between STIC and subsequent high-grade serous carcinoma in BRCA1/2 mutation carriers several years after risk-reducing salpingo-oophorectomy. Gynecol Oncol 2024; 187:113-119. [PMID: 38759517 DOI: 10.1016/j.ygyno.2024.05.010] [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: 01/05/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVE The majority of high-grade serous carcinomas (HGSC) of the ovary, fallopian tube, and peritoneum arise from the precursor lesion called serous tubal intraepithelial carcinoma (STIC). It has been postulated that cells from STICs exfoliate into the peritoneal cavity and give rise to peritoneal HGSC several years later. While co-existent STICs and HGSCs have been reported to share similarities in their mutational profiles, clonal relationship between temporally distant STICs and HGSCs have been infrequently studied and the natural history of STICs remains poorly understood. METHODS We performed focused searches in two national databases from the Netherlands and identified a series of BRCA1/2 germline pathogenic variant (GPV) carriers (n = 7) who had STIC, and no detectable invasive carcinoma, at the time of their risk-reducing salpingo-oophorectomy (RRSO), and later developed peritoneal HGSC. The clonal relationship between these STICs and HGSCs was investigated by comparing their genetic mutational profile by performing next-generation targeted sequencing. RESULTS Identical pathogenic mutations and loss of heterozygosity of TP53 were identified in the STICs and HGSCs of five of the seven patients (71%), confirming the clonal relationship of the lesions. Median interval for developing HGSC after RRSO was 59 months (range: 24-118 months). CONCLUSION Our results indicate that cells from STIC can shed into the peritoneal cavity and give rise to HGSC after long lag periods in BRCA1/2 GPV carriers, and argues in favor of the hypothesis that STIC lesions may metastasize.
Collapse
Affiliation(s)
- C B van den Berg
- Department of Gynecologic Oncology, Erasmus MC Cancer Center, University Medical Center, Rotterdam, the Netherlands.
| | - S Dasgupta
- Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, United States
| | - P C Ewing-Graham
- Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - J Bart
- Department of Pathology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - J Bulten
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - K N Gaarenstroom
- Department of Gynecologic Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - J A de Hullu
- Department of Gynecologic Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C H Mom
- Department of Gynecologic Oncology, Cancer Center Amsterdam, Amsterdam University Medical Center, Center for Gynecologic Oncology Amsterdam, the Netherlands
| | - M J E Mourits
- Department of Gynecologic Oncology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - M P Steenbeek
- Department of Gynecologic Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - R van Marion
- Department of Pathology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - H J van Beekhuizen
- Department of Gynecologic Oncology, Erasmus MC Cancer Center, University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
18
|
Carballo EV, Kim KH, Penn CA. Trends in estimated PARP inhibitor eligibility and benefit among US epithelial ovarian cancer patients. Gynecol Oncol 2024; 187:204-211. [PMID: 38795509 DOI: 10.1016/j.ygyno.2024.05.014] [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: 01/16/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE To estimate the annual percentage of patients with epithelial ovarian cancer (EOC) who could be eligible for and benefit from PARP inhibitor therapy amidst changing US Food and Drug Administration (FDA)-approved indications. METHODS This is a simulated retrospective observational study using publicly available data on patients with advanced-stage EOC. PARPi eligibility is based on FDA approvals and withdrawals from 2014 through 2023, along with published demographic and genomic data. Clinical trial data is used to estimate treatment benefit. PARPi including olaparib, niraparib, and rucaparib are analyzed in aggregate with sub-analyses by molecular classification and treatment timing. Results are reported as the percentage of EOC patients appropriate for any cancer-directed therapy. RESULTS PARPi were approved for 9 different indications in EOC between 2014 and 2021; reduced to 6 indications by 2023. Eligibility increased from 2.0% (95% CI,1.3%-1.6%) in 2014 to a maximum of 93.4% (95% CI,90.1%-94.6%) in 2021. The maximum percentage of patients with 2-year PFS benefit was 22.0% (95% CI, 17.2%-26.8%) in 2021, projected to decrease to 13.0% (95% CI, 9.9%-15.9%) in 2024. Most of this decrease was seen in the homologous recombination deficient, BRCA wild-type population (8.4% to 4.0%). CONCLUSIONS PARPi eligibility increased at a greater rate than benefit resulting in a low population-level benefit-to-eligibility ratio until 2021. Recent FDA withdrawals improved this ratio with an accompanied decrease in the absolute number of patients benefiting. To further optimize population-level benefit-to-eligibility ratio of targeted therapies in ovarian cancer, we need to identify better biomarkers, treatment combinations, and novel therapeutic targets.
Collapse
Affiliation(s)
- Erica V Carballo
- Division of Gynecologic Oncology, Vanderbilt University Medical Center, United States of America.
| | - Kenneth H Kim
- Division of Gynecologic Oncology, Cedars-Sinai Medical Center, United States of America
| | - Courtney A Penn
- Division of Gynecologic Oncology, Vanderbilt University Medical Center, United States of America
| |
Collapse
|
19
|
Szeőcs D, Vida B, Petővári G, Póliska S, Janka E, Sipos A, Uray K, Sebestyén A, Krasznai Z, Bai P. Cell-free ascites from ovarian cancer patients induces Warburg metabolism and cell proliferation through TGFβ-ERK signaling. GeroScience 2024; 46:3581-3597. [PMID: 38196068 PMCID: PMC11226691 DOI: 10.1007/s11357-023-01056-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/24/2023] [Indexed: 01/11/2024] Open
Abstract
Ascites plays a key role in supporting the metastatic potential of ovarian cancer cells. Shear stress and carry-over of cancer cells by ascites flow support carcinogenesis and metastasis formation. In addition, soluble factors may participate in the procarcinogenic effects of ascites in ovarian cancer. This study aimed to determine the biological effects of cell-free ascites on carcinogenesis in ovarian cancer cells. Cell-free ascites from ovarian cancer patients (ASC) non-selectively induced cell proliferation in multiple models of ovarian cancer and untransformed primary human dermal fibroblasts. Furthermore, ASC induced a Warburg-type rearrangement of cellular metabolism in A2780 ovarian cancer cells characterized by increases in cellular oxygen consumption and glycolytic flux; increases in glycolytic flux were dominant. ASC induced mitochondrial uncoupling and fundamentally reduced fatty acid oxidation. Ascites-elicited effects were uniform among ascites specimens. ASC-elicited transcriptomic changes in A2780 ovarian cancer cells included induction of the TGFβ-ERK/MEK pathway, which plays a key role in inducing cell proliferation and oncometabolism. ASC-induced gene expression changes, as well as the overexpression of members of the TGFβ signaling system, were associated with poor survival in ovarian cancer patients. We provided evidence that the activation of the autocrine/paracrine of TGFβ signaling system may be present in bladder urothelial carcinoma and stomach adenocarcinoma. Database analysis suggests that the TGFβ system may feed forward bladder urothelial carcinoma and stomach adenocarcinoma. Soluble components of ASC support the progression of ovarian cancer. These results suggest that reducing ascites production may play an essential role in the treatment of ovarian cancer by inhibiting the progression and reducing the severity of the disease.
Collapse
Affiliation(s)
- Dóra Szeőcs
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
- Center of Excellence, The Hungarian Academy of Sciences, Debrecen, Hungary
| | - Beáta Vida
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
| | - Gábor Petővári
- Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Szilárd Póliska
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
| | - Eszter Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
| | - Adrienn Sipos
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
- Center of Excellence, The Hungarian Academy of Sciences, Debrecen, Hungary
- HUN-REN-DE Cell Biology and Signaling Research Group, Debrecen, Hungary, 4032
| | - Karen Uray
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
- Center of Excellence, The Hungarian Academy of Sciences, Debrecen, Hungary
| | - Anna Sebestyén
- Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Zoárd Krasznai
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032
| | - Péter Bai
- Department of Medical Chemistry, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032.
- Center of Excellence, The Hungarian Academy of Sciences, Debrecen, Hungary.
- HUN-REN-DE Cell Biology and Signaling Research Group, Debrecen, Hungary, 4032.
- MTA-DE Lendület Laboratory of Cellular Metabolism, Debrecen, Hungary, 4032.
- Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary, 4032.
| |
Collapse
|
20
|
Zenatri M, Perennec T, Michon C, Gernier F, Grellard JM, Piloquet FX, Dubot-Poitelon C, Kalbacher E, Tredan O, Augereau P, Pautier P, Fey L, Joly F, Frenel JS. Pharmacogenomic predictor of long-term residual chemotherapy-induced peripheral neuropathy in ovarian cancer survivors: A substudy of the GINECO Vivrovaire study. Gynecol Oncol 2024; 187:139-144. [PMID: 38776631 DOI: 10.1016/j.ygyno.2024.04.021] [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: 02/23/2024] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Chemotherapy (CT) remains a backbone treatment of epithelial ovarian cancer (EOC) inducing persistent peripheral neuropathy (CIPN). Using a dedicated patient-reported outcome tool, this study investigated persistent CIPN and its pharmacogenetic predictors in a cohort of long-term EOC survivors. METHODS Vivrovaire was a French multicenter cohort of patients with EOC free of disease 3 years after CT completion. Persistent CIPN was assessed using the FACT/GOG-Ntx4 self-questionnaire. The association of homozygous (hom) or heterozygous (het) single nucleotide polymorphisms (SNPs) in selected genes was evaluated. RESULTS 130 patients were included with a median time from CT completion of 63 [35-180] months. The median CIPN score was 37 [18-44], with 35 (26.9%) patients reporting severe CIPN (<33). SNPs were identified as follows: CYP2C8 [hom, n = 32 (24.6%)/het, n = 99, (76.2%)]; CYP3A4 [hom, n = 0 (0%)/het, n = 8 (6.2%)], ERCC1 [hom, n = 21 (16.2%)/het, n = 57 (43.8%)], and XPC [hom, n = 45 (34.6%)/het, n = 66 (50.8%)]. In univariate analysis, the identification of ≥1 hom SNP was associated with a lower CIPN score (continuous variable; p = 0.045). Patients harboring hom or het CYP2C8_rs1934951 SNP reported more likely severe CIPN (threshold <33) score (OR 2.482; 95% CI [1.126-5.47], p = 0.024). In the multivariate analyses, age, interval from CT completion, type and number of CT courses were not significantly associated with CIPN score (OR 5.165, 95% CI [0.478-55.83], p = 0.176). CONCLUSIONS Persistent CIPN is common among ovarian cancer long-term survivors. CYP2C8_rs1934951 SNP may be associated with severe residual CIPN in EOC survivors. More studies are warranted to identify predictive factors of CIPN.
Collapse
Affiliation(s)
- M Zenatri
- Department of Medical Oncology, Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - T Perennec
- Radiation Oncology Department, Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - C Michon
- Department of Biopathology, Institut de Cancerologie de l'Ouest, Centre Paul Papin, Angers, France
| | - F Gernier
- Clinical Research Department, Centre Francois Baclesse, Caen, France
| | - J-M Grellard
- Clinical Research Department, Centre Francois Baclesse, Caen, France
| | - F-X Piloquet
- Department of Medical Oncology, Institut de Cancerologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - C Dubot-Poitelon
- Medical Oncology Department, Centre Francois Baclesse, Unicaen University, Caen, France
| | - E Kalbacher
- Oncology Department, CHRU Besancon - Hopital Jean Minjoz, Besancon, France
| | - O Tredan
- Medical Oncology, Centre Léon Bérard, Lyon, France
| | - P Augereau
- Medical Oncology Department, Institut de Cancerologie de l'Ouest, Centre Paul Papin, Angers, France
| | - P Pautier
- Medicine Department, Institut Gustave Roussy, Villejuif, France
| | - L Fey
- Department of Biopathology, Institut de Cancerologie de l'Ouest, Centre Paul Papin, Angers, France
| | - F Joly
- Medical Oncology Department, Centre Francois Baclesse, Unicaen University, Caen, France
| | - J-S Frenel
- Medical Oncology Department, Institut de Cancerologie de l'Ouest, Centre Rene Gauducheau, GINECO Group and GINEGEPS, Saint-Herblain, France.
| |
Collapse
|
21
|
Ostrowski T, Litwiński J, Gęca K, Świetlicka I, Polkowski WP, Skórzewska M. A Clinician's perspective on the role of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer management. Surg Oncol 2024; 56:102117. [PMID: 39096575 DOI: 10.1016/j.suronc.2024.102117] [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: 01/08/2024] [Revised: 07/02/2024] [Accepted: 07/30/2024] [Indexed: 08/05/2024]
Abstract
The prevention of intraperitoneal spread is of utmost importance in the management of advanced ovarian cancer (OC), thus demanding the exploration of innovative treatment techniques. The propensity of OC to spread to the peritoneum has highlighted the potential of local therapy as a promising approach. Among the proposed treatments thus far are several local intraperitoneal therapies, with hyperthermic intraperitoneal chemotherapy (HIPEC) being one of them. The application of HIPEC may potentially enhance the survival rates of patients with OC, as indicated by a recent publication of high-quality prospective data. The incorporation of HIPEC in conjunction with primary cytoreductive surgery (CRS) does not have a significant impact on either overall survival (OS) or disease-free survival (DFS). However, the incorporation of HIPEC alongside interval CRS, followed by systemic chemotherapy (CTH), markedly enhances both OS and DFS. The most recent data also substantiates the effectiveness of HIPEC in recurrent ovarian cancer (ROC), resulting in an improvement of survival outcomes. Additional research will contribute to the improvement of the HIPEC regimen and technique, as well as the precise identification of patients who will gain the most advantage from this treatment approach. It is recommended to discuss and update (inter)national clinical guidelines for managing patients with advanced OC and peritoneal involvement.
Collapse
Affiliation(s)
- Tomasz Ostrowski
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland
| | - Jakub Litwiński
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland
| | - Katarzyna Gęca
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland.
| | - Izabela Świetlicka
- Department of Biophysics of Biological Structures and Systems, University of Life Sciences in Lublin, Poland
| | - Wojciech P Polkowski
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland
| | - Magdalena Skórzewska
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St., 20-080, Lublin, Poland
| |
Collapse
|
22
|
Ibanez KR, Donohue D, Malys T, Lee JM. Gynecologic Cancer InterGroup CA125 response has a high negative predictive value for CHK1 inhibitor RECIST response in recurrent ovarian cancer. Sci Rep 2024; 14:17459. [PMID: 39075200 PMCID: PMC11286792 DOI: 10.1038/s41598-024-68338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/22/2024] [Indexed: 07/31/2024] Open
Abstract
We investigated the association of CA125 response with prognosis and RECIST response/progressive disease (PD) criteria in recurrent high grade serous ovarian cancer (HGSOC) patients treated with a cell cycle checkpoint kinase 1 inhibitor (CHK1i), prexasertib. 81 patients had measurable disease per RECISTv1.1, of which 72 and 70 were measurable by Gynecologic Cancer InterGroup (GCIG) CA125 response and PD criteria, respectively. Univariate and multivariate analyses showed that GCIG CA125 response (n = 32) is associated with improved progression-free survival (PFS) and overall survival (OS) compared to no GCIG CA125 response (n = 40) (median PFS 8.0 vs. 3.5 months [HR: 0.30, 95% CI: 0.18-0.51, p < 0.0001]; median OS 19.8 vs. 10.0 months [HR: 0.38, 95% CI: 0.23-0.64, p < 0.001]) independent of BRCA mutation status, platinum-sensitivity, previous PARP inhibitor therapy, ECOG performance status, and FIGO stage. Notably, GCIG CA125 response had a high negative predictive value (NPV: 93%, 95% CI: 80-98), but poor positive predictive value (PPV: 53%, 95% CI: 35-71) in predicting RECIST response. CA125 PD criteria also showed poor concordance with RECIST PD (PPV 56%, 95% CI: 40-71; NPV 33%, 95% CI: 17-54). Therefore, serum CA125 may be useful as a highly accessible prognostic and predictive biomarker to CHK1i therapy in recurrent HGSOC.
Collapse
Affiliation(s)
- Kristen R Ibanez
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10, Room 6B12, Bethesda, MD, 20892, USA
| | - Duncan Donohue
- Statistical Consulting and Scientific Programming Group, Computer and Statistical Services, Data Management Services, Inc. (a BRMI Company), NCI, Frederick, MD, 21702, USA
| | - Tyler Malys
- Statistical Consulting and Scientific Programming Group, Computer and Statistical Services, Data Management Services, Inc. (a BRMI Company), NCI, Frederick, MD, 21702, USA
| | - Jung-Min Lee
- Women's Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10, Room 6B12, Bethesda, MD, 20892, USA.
| |
Collapse
|
23
|
Negri S, Fisch C, de Hullu JA, van Bommel M, Simons M, Bogaerts J, Hermens RPMG, Steenbeek MP. Diagnosis and management of isolated serous tubal intraepithelial carcinoma: A qualitative focus group study. BJOG 2024. [PMID: 39054407 DOI: 10.1111/1471-0528.17919] [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: 02/21/2024] [Revised: 06/27/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE A Serous Tubal Intraepithelial Carcinoma (STIC) without concomitant invasive carcinoma is occasionally identified and associated with a high risk of subsequent peritoneal carcinomatosis. Management needs optimisation. This study explores professionals' opinions and clinical practices regarding the diagnosis, counselling, treatment and follow-up of isolated STIC to facilitate clinical decision making and optimise the direction of future research. A secondary aim is to assess international clinical guidelines. DESIGN Focus group study. SETTING Four online sessions. POPULATION International panel (n = 12 countries) of gynaecologists, gynaecologic oncologists, pathologists and medical oncologists (n = 49). METHODS A semi-structured interview guide was used. Two independent researchers analysed transcripts by open and axial coding. Results were organised in domains. Relevant (inter)national guidelines were screened for recommendations regarding isolated STIC. MAIN OUTCOME MEASURES Professionals' opinions and clinical practices regarding isolated STIC management. RESULTS Regarding pathology, most professionals identified the SEE-FIM protocol as standard of care for high-risk patients, whereas variation exists in the histopathological examination of fallopian tubes in the general population. Confirmation of STIC diagnosis by a specialised pathologist was recommended. Regarding work-up and follow-up after STIC diagnosis, there was variety and discordance. Data on outcomes is limited. As for treatment, chemotherapy and PARP inhibitors were not recommended by most. Eleven guidelines provided limited recommendations. CONCLUSIONS We identified recommendations and highlighted knowledge gaps in the diagnosis and management of isolated STIC. Moreover, recommendations in clinical guidelines are limited. There is an agreed need for international collaboration for the prospective registration of isolated STIC.
Collapse
Affiliation(s)
- Serena Negri
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Charlotte Fisch
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joanne A de Hullu
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Majke van Bommel
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Michiel Simons
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Joep Bogaerts
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Miranda P Steenbeek
- Department of Obstetrics and Gynecology, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
24
|
Masvidal Hernandez M, Cros Costa S, Salvador Coloma C, Quilez Cutillas A, Barretina-Ginesta MP, Cotes Sanchís A. First-line PARP inhibitor maintenance treatment in ovarian carcinoma for older adult women: a review of the current literature. Clin Transl Oncol 2024:10.1007/s12094-024-03609-y. [PMID: 39030437 DOI: 10.1007/s12094-024-03609-y] [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: 04/16/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024]
Abstract
Ovarian cancer (OC) is the leading cause of death in women with gynecological cancers. Its diagnosis is more likely in advanced ages, with the older population being the most seen in consultations. Poly(ADP-ribose) inhibitors (PARPi) have changed OC clinical practice and evolution, showing great benefit. However, there is a lack of evidence of PARPi in elderly population that can impact the therapeutic decision and the safety/efficacy. It is necessary to avoid age as limiting factor in PARPis prescription. We conducted a review of the most relevant randomized phase III trials of maintenance PARPi after first-line treatment of advanced OC. We observed the lack of a single criterion for considering older patients, varying among trials. There is a benefit of PARPis in different populations. However, PARPi effect on quality of life is not reported, something of great relevance considering their vulnerability. Measures are needed to benefit older patients to better adapt PARPi treatment.
Collapse
Affiliation(s)
- Maria Masvidal Hernandez
- Medical Oncology, Institut d'Oncologia de La Catalunya Sud, Hospital Universitari Sant Joan de Reus, Institut d'Investigació Sanitària Pere Virgili (IIPV), Universitat Rovira I Virgili, 46204, Reus, Tarragona, Spain
| | - Sara Cros Costa
- Medical Oncology, Hospital General de Granollers, Barcelona, Spain
| | - Carmen Salvador Coloma
- Medical Oncology, Hospital Lluís Alcanyís de Xàtiva, Carretera Xativa-Silla km2 CP, 46800, Valencia, Spain.
| | - Alicia Quilez Cutillas
- Medical Oncology. Service de Oncologie Médicale, Centre Hospitalier Universitaire de Saint Étienne, Saint-Priest-en-Jarez, France
| | - Maria-Pilar Barretina-Ginesta
- Medical Oncology Department, Institut Català d'Oncologia, Girona; Precision Oncology Group, IDIBGI; Medical Sciences Department, Universitat de Girona, Girona, Spain
| | | |
Collapse
|
25
|
Tóth R, Tóth Z, Lőczi L, Török M, Ács N, Várbíró S, Keszthelyi M, Lintner B. Management of Malignant Bowel Obstruction in Patients with Gynaecological Cancer: A Systematic Review. J Clin Med 2024; 13:4213. [PMID: 39064252 PMCID: PMC11277705 DOI: 10.3390/jcm13144213] [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: 06/16/2024] [Revised: 07/06/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives: This systematic review aimed to evaluate current surgical and non-surgical management strategies for malignant bowel obstruction (MBO) in patients with gynaecological cancer. Methods: Comprehensive literature searches were conducted across MEDLINE, Embase, CENTRAL, and Scopus, without restrictions on language or publication date. Following the removal of duplicates, 4866 articles were screened, with 34 meeting the inclusion criteria. Results: Surgical intervention remains the definitive treatment for MBO, offering longer symptom-free periods and improved survival, particularly when conservative methods fail. However, the selection of surgical candidates is crucial due to the high risk of morbidity and the potential for significant complications. Non-surgical treatments, such as the use of Gastrografin, Octreotide, and Dexamethasone, along with invasive procedures like nasogastric tubing, percutaneous gastrostomy, and stent placement, offer varying degrees of symptom relief and are often considered when surgery is not feasible. Conclusions: In this article we provide a potential therapeutic algorithm for the management of patients with MBO. This review underscores the urgent need for high-quality research to develop clear, evidence-based guidelines for MBO management in patients with gynaecologic cancer. Establishing standardised protocols will improve patient outcomes by aiding clinicians in making informed, individualised treatment decisions.
Collapse
Affiliation(s)
- Richárd Tóth
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
| | - Zsófia Tóth
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
| | - Lotti Lőczi
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
| | - Marianna Török
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary
- Department of Obstetrics and Gynaecology, University of Szeged, 6725 Szeged, Hungary
| | - Márton Keszthelyi
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
| | - Balázs Lintner
- Department of Obstetrics and Gynaecology, Semmelweis University, 1082 Budapest, Hungary; (R.T.); (Z.T.); (L.L.); (M.T.); (N.Á.); (S.V.); (B.L.)
| |
Collapse
|
26
|
Assavapokee N, Santibenchakul S, Ratree S, Lertkhachonsuk R, Phoolcharoen N. Examining the impact of age on chemotherapy completion in epithelial ovarian, fallopian tube and primary peritoneal cancer: a retrospective cohort study in Thailand. BMJ Open 2024; 14:e083270. [PMID: 39025817 PMCID: PMC11261680 DOI: 10.1136/bmjopen-2023-083270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE To explore the difference in chemotherapy completion and reasons for discontinuation between older (≥70 years) and younger (<70 years) patients. DESIGN Retrospective cohort study. SETTING Single tertiary centre in Thailand. PARTICIPANTS The patients who received chemotherapy from 1 January 2009 to 30 June 2021 were included and followed up until 30 June 2022. Of the 757 patients with epithelial ovarian, fallopian tube and primary peritoneal cancer (EOC), 108 were in the older group and 649 were in the younger group. PRIMARY AND SECONDARY OUTCOME MEASURES The difference in chemotherapy completion, the association between younger and older patients and early discontinuation of chemotherapy. RESULTS The proportion of chemotherapy completion was significantly lower in older versus younger patients (84.3% versus 92.6%, p=0.007). Excluding discontinuation due to disease progression, the chemotherapy completion was comparable (93.5 versus 95.7%, p=0.456). Dose reduction and grade 3-4 hematotoxicity occurred more often in the older group. The univariable logistic regression model showed that older age (≥70 years) was significantly associated with early chemotherapy discontinuation (OR 2.39; 95% CI 1.29-4.24). However, after adjusting for potential confounders, age was not significantly associated with early discontinuation (OR 1.20; 95% CI 0.54-2.66). Multiple comorbidities and types of surgery were identified as independent risk factors for chemotherapy discontinuation. CONCLUSION The completion of chemotherapy was observed in a majority of older adults with EOC. Age is not the only determinant of chemotherapy completion. Comorbidity and disease status are crucial for determining chemotherapy discontinuation.
Collapse
Affiliation(s)
- Nicha Assavapokee
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somsook Santibenchakul
- Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimon Ratree
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ruangsak Lertkhachonsuk
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Natacha Phoolcharoen
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
27
|
Ray-Coquard IL, Savoye AM, Schiffler C, Mouret-Reynier MA, Derbel O, Kalbacher E, LeHeurteur M, Martinez A, Cornila C, Martinez M, Bengrine Lefevre L, Priou F, Cloarec N, Venat L, Selle F, Berton D, Collard O, Coquan E, Le Saux O, Treilleux I, Gouerant S, Angelergues A, Joly F, Tredan O. Neoadjuvant and adjuvant pembrolizumab in advanced high-grade serous carcinoma: the randomized phase II NeoPembrOV clinical trial. Nat Commun 2024; 15:5931. [PMID: 39013870 PMCID: PMC11252284 DOI: 10.1038/s41467-024-46999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/18/2024] [Indexed: 07/18/2024] Open
Abstract
This open-label, non-comparative, 2:1 randomized, phase II trial (NCT03275506) in women with stage IIIC/IV high-grade serous carcinoma (HGSC) for whom upfront complete resection was unachievable assessed whether adding pembrolizumab (200 mg every 3 weeks) to standard-of-care carboplatin plus paclitaxel yielded a complete resection rate (CRR) of at least 50%. Postoperatively patients continued assigned treatment for a maximum of 2 years. Postoperative bevacizumab was optional. The primary endpoint was independently assessed CRR at interval debulking surgery. Secondary endpoints were Completeness of Cytoreduction Index (CCI) and peritoneal cancer index (PCI) scores, objective and best response rates, progression-free survival, overall survival, safety, postoperative morbidity, and pathological complete response. The CRR in 61 pembrolizumab-treated patients was 74% (one-sided 95% CI = 63%), exceeding the prespecified ≥50% threshold and meeting the primary objective. The CRR without pembrolizumab was 70% (one-sided 95% CI = 54%). In the remaining patients CCI scores were ≥3 in 27% of the standard-of-care group and 18% of the investigational group and CC1 in 3% of the investigational group. PCI score decreased by a mean of 9.6 in the standard-of-care group and 10.2 in the investigational group. Objective response rates were 60% and 72%, respectively, and best overall response rates were 83% and 90%, respectively. Progression-free survival was similar with the two regimens (median 20.8 versus 19.4 months in the standard-of-care versus investigational arms, respectively) but overall survival favored pembrolizumab-containing therapy (median 35.3 versus 49.8 months, respectively). The most common grade ≥3 adverse events with pembrolizumab-containing therapy were anemia during neoadjuvant therapy and infection/fever postoperatively. Pembrolizumab was discontinued prematurely because of adverse events in 23% of pembrolizumab-treated patients. Combining pembrolizumab with neoadjuvant chemotherapy is feasible for HGSC considered not completely resectable; observed activity in some subgroups justifies further evaluation to improve understanding of the role of immunotherapy in HGSC.
Collapse
MESH Headings
- Humans
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/administration & dosage
- Female
- Middle Aged
- Aged
- Neoadjuvant Therapy/methods
- Carboplatin/therapeutic use
- Carboplatin/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Paclitaxel/therapeutic use
- Paclitaxel/administration & dosage
- Paclitaxel/adverse effects
- Chemotherapy, Adjuvant/methods
- Adult
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Ovarian Neoplasms/mortality
- Cystadenocarcinoma, Serous/drug therapy
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/surgery
- Cystadenocarcinoma, Serous/mortality
- Progression-Free Survival
- Cytoreduction Surgical Procedures
- Neoplasm Staging
Collapse
Affiliation(s)
- Isabelle L Ray-Coquard
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre Léon Bérard, University Claude Bernard, Lyon, France.
| | | | - Camille Schiffler
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre Léon Bérard, University Claude Bernard, Lyon, France
| | | | - Olfa Derbel
- GINECO and Institut de Cancérologie, Hôpital Privé Jean Mermoz, Lyon, France
| | - Elsa Kalbacher
- GINECO and Centre Hospitalier Universitaire Jean Minjoz, Besançon, France
| | - Marianne LeHeurteur
- GINECO and Medical Oncology Department, Centre Henri-Becquerel, Rouen, France
| | - Alejandra Martinez
- GINECO and Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse (IUCT) Oncopole, Toulouse, France
| | - Corina Cornila
- GINECO and Centre Hospitalier Régional d'Orléans, Orleans, France
| | | | | | - Frank Priou
- GINECO and Centre Hospitalier Départemental Vendée, La Roche-Sur-Yon, France
| | - Nicolas Cloarec
- GINECO and Centre Hospitalier Henri Duffaut d'Avignon, Avignon, France
| | - Laurence Venat
- GINECO and Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Frédéric Selle
- GINECO and Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Dominique Berton
- GINECO and Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Olivier Collard
- GINECO and Institut de Cancérologie de la Loire, Saint-Priest-en-Jarez, France
- Center of Medical Oncology, Hôpital Privé de la Loire, Saint-Etienne, France
| | - Elodie Coquan
- GINECO and Department of Medical Oncology, Centre François Baclesse, University Caen Normandie, Caen, France
| | - Olivia Le Saux
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre Léon Bérard, University Claude Bernard, Lyon, France
- Cancer Research Center of Lyon (CRCL), UMR INSERM 1052, Centre Léon Bérard, CNRS 5286, Lyon, France
| | - Isabelle Treilleux
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Centre Léon Bérard, University Claude Bernard, Lyon, France
| | - Sophie Gouerant
- GINECO and Medical Oncology Department, Centre Henri-Becquerel, Rouen, France
| | | | - Florence Joly
- GINECO and Department of Medical Oncology, Centre François Baclesse, University Caen Normandie, Caen, France
| | - Olivier Tredan
- GINECO and Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| |
Collapse
|
28
|
Hua M, Chen Y, Jia M, Lv W, Xu Y, Zhang Y. RNA-binding protein THUMPD2 inhibits proliferation and promotes metastasis in epithelial ovarian cancer. Heliyon 2024; 10:e33201. [PMID: 39071668 PMCID: PMC11279259 DOI: 10.1016/j.heliyon.2024.e33201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/30/2024] Open
Abstract
Ovarian cancer (OC) is a common and lethal gynaecological malignancy. RNA-binding proteins (RBPs) play a crucial role in governing RNA metabolism and have been implicated in the development and progression of diverse cancer types. Slight alterations in RBPs' expression or activity can induce substantial modifications in the regulatory network. THUMPD2, as member of the RBP family, was found to have differential expression in ovarian cancer, with the mechanism has not been studied yet. In this study, THUMPD2 protein was found to be weakly expressed in the early (I + II) stages of OC (P = 0.013), with a low expression rate of 78.6 %, and highly expressed in late (III + IV) stages (P = 0.009), with a high expression rate of 84.8 %. The shRNA-mediated knockdown of THUMPD2 in OVCAR3 and SKOV3 cells resulted in increased cell proliferation but inhibited metastasis, whereas THUMPD2 overexpression had the opposite effect. THUMPD2 overexpression suppressed tumour growth in vivo. Conversely, low THUMPD2 expression promoted tumour growth. Furthermore, we identified the potential target genes and pathways of THUMPD2 using GO and KEGG analyses, which were related to the centrosome, microtubules, cell cycle, and extracellular matrix. We demonstrated that low expression of THUMPD2 in the early stage promoted tumour growth and high expression in the late stage promoted tumour metastasis. Our findings reveal the dual function of THUMPD2 in OC and suggest that THUMPD2 may serve as a therapeutic target for the treatment of OC.
Collapse
Affiliation(s)
- Minhui Hua
- Suzhou Medical College of Soochow University, Suzhou, 215123, China
- Department of Gynecology and Obstetrics, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yujie Chen
- Department of Gynecology and Obstetrics, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Meiqun Jia
- Department of Gynecology, Affiliated Tumor Hospital of Nantong University, Nantong, 226001, China
| | - Wenxuan Lv
- Department of Gynecology and Obstetrics, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yunzhao Xu
- Department of Gynecology and Obstetrics, Affiliated Hospital of Nantong University, Nantong, 226001, China
| | - Yuquan Zhang
- Suzhou Medical College of Soochow University, Suzhou, 215123, China
- Department of Gynecology and Obstetrics, Affiliated Hospital of Nantong University, Nantong, 226001, China
| |
Collapse
|
29
|
Polan RM, Ali-Fehmi R, Grace AK, Mattei LH, Tanner EJ, Morris RT. Occult residual ovarian tissue at the time of minimally invasive risk reducing surgery in women with BRCA mutations. Gynecol Oncol 2024; 189:37-40. [PMID: 39003959 DOI: 10.1016/j.ygyno.2024.07.005] [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: 06/17/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVE To describe extension of ovarian tissue beyond visible and National Comprehensive Cancer Network recommended margins among patients with BRCA mutations undergoing minimally invasive risk-reducing salpingo-oophorectomy. METHODS A prospective study of patients with BRCA mutations who underwent minimally invasive risk-reducing bilateral salpingo-oophorectomy was conducted. Patient enrollment occurred between October 2021 and 2023. Tissue specimens were analyzed according to the Sectioning and Extensively Examining the Fimbriated End protocol. RESULTS Twenty women with BRCA mutations were prospectively enrolled. All patients underwent minimally invasive surgery with 70% undergoing concurrent hysterectomy (n = 14). Approximately half of these procedures were performed with robotic assistance (n = 9, 45%). One patient was admitted overnight (5%); the other nineteen were discharged on the day of surgery (95%). One patient experienced a major complication and required readmission (5%). Extension of ovarian tissue beyond the visible ovary was noted on pathologic examination of six specimens (30%). In one patient this was observed on the left (17%), in three on the right (50%), and in two bilateral extension (33%) was noted. The distance ovarian stroma extended microscopically beyond the visible ovary was between 2 and 14 mm, with a median of 5 mm. Among patients with microscopic extension of ovarian tissue, the majority (n = 5, 83%) had a BRCA2 mutation. CONCLUSION In women with BRCA mutations undergoing risk-reducing minimally invasive surgery, approximately one third had microscopic extension of ovarian stroma beyond the visible ovary. Current guidelines which recommend resection of at least 20 mm of tissue beyond the visible ovary are likely adequate in this population.
Collapse
Affiliation(s)
- Rosa M Polan
- Department of Gynecologic Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
| | - Rouba Ali-Fehmi
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Anne K Grace
- Department of Gynecologic Oncology, Northwestern Prentice Women's Hospital, Chicago, IL, USA
| | - Larissa H Mattei
- Department of Gynecologic Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Edward J Tanner
- Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Robert T Morris
- Department of Gynecologic Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| |
Collapse
|
30
|
Wang Q, Liu H, Shen Y, Shen L, Li J, Feng W. The impact of Paclitaxel-based hyperthermic intraperitoneal chemotherapy in advanced high-grade serous ovarian cancer patients - interim analysis of safety and immediate efficacy of a randomized control trial (C-HOC trial). J Ovarian Res 2024; 17:145. [PMID: 38997720 PMCID: PMC11241942 DOI: 10.1186/s13048-024-01468-3] [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: 09/24/2023] [Accepted: 06/29/2024] [Indexed: 07/14/2024] Open
Abstract
OBJECTIVE This study evaluates the potential superiority of combining paclitaxel-based hyperthermic intraperitoneal chemotherapy (HIPEC) with sequential intravenous neoadjuvant chemotherapy over intravenous neoadjuvant chemotherapy alone in Chinese patients with Federation of Gynecology and Obstetrics (FIGO) stage IIIC, IVA and IVB high-grade serous ovarian/fallopian tube carcinoma (HGSOC). This interim analysis focuses on the safety and immediate efficacy of both regimens to determine the feasibility of the planned trial (C-HOC Trial). METHODS In a single-center, open-label, randomized control trial, FIGO stage IIIC, IVA, and IVB HGSOC patients (FAGOTTI score ≥ 8 during laparoscopic exploration) unsuitable for optimal cytoreduction in primary debulking surgery (PDS) were randomized 2:1 during laparoscopic exploration. The Experiment Group (HIPEC Group) received one cycle of intraperitoneal neoadjuvant laparoscopic hyperthermic intraperitoneal chemotherapy (paclitaxel) followed by three cycles of intravenous chemotherapy (paclitaxel plus carboplatin), while the Control Group received only three cycles of intravenous chemotherapy. Both groups subsequently underwent interval debulking surgery (IDS). The adverse effects of chemotherapy, postoperative complications, and pathological chemotherapy response scores (CRS) after IDS were compared. RESULTS Among 65 enrolled patients, 39 HIPEC Group and 21 Control Group patients underwent IDS. Grade 3-4 chemotherapy-related adverse effects were primarily hematological with no significant differences between the two groups. The HIPEC Group exhibited a higher proportion of CRS 3 (20.5% vs. 4.8%; P = 0.000). R0 resection rates in IDS were 69.2% (HIPEC Group) and 66.7% (Control Group). R2 resection occurred in 2.6% (HIPEC Group) and 14.3% (Control Group) cases. No reoperations or postoperative deaths were reported, and complications were managed conservatively. CONCLUSIONS Combining HIPEC with IV NACT in treating ovarian cancer demonstrated safety and feasibility, with no increased chemotherapy-related adverse effects or postoperative complications. HIPEC improved tumor response to neoadjuvant chemotherapy, potentially enhancing progression-free survival (PFS). However, the final overall survival results are pending, determining if HIPEC combined with IV NACT is superior to IV NACT alone.
Collapse
Affiliation(s)
- Qun Wang
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Hua Liu
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuhong Shen
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lifei Shen
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian Li
- Clinical Research Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiwei Feng
- Department of Gynecology and Obstetrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
31
|
Chen Y, Johnson JD, Jayamohan S, He Y, Venkata PP, Jamwal D, Alejo S, Zou Y, Lai Z, Viswanadhapalli S, Vadlamudi RK, Kost E, Sareddy GR. KDM1A/LSD1 inhibition enhances chemotherapy response in ovarian cancer. Mol Carcinog 2024. [PMID: 38990091 DOI: 10.1002/mc.23792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/13/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024]
Abstract
Ovarian cancer (OCa) is the deadliest of all gynecological cancers. The standard treatment for OCa is platinum-based chemotherapy, such as carboplatin or cisplatin in combination with paclitaxel. Most patients are initially responsive to these treatments; however, nearly 90% will develop recurrence and inevitably succumb to chemotherapy-resistant disease. Recent studies have revealed that the epigenetic modifier lysine-specific histone demethylase 1A (KDM1A/LSD1) is highly overexpressed in OCa. However, the role of KDM1A in chemoresistance and whether its inhibition enhances chemotherapy response in OCa remains uncertain. Analysis of TCGA datasets revealed that KDM1A expression is high in patients who poorly respond to chemotherapy. Western blot analysis show that treatment with chemotherapy drugs cisplatin, carboplatin, and paclitaxel increased KDM1A expression in OCa cells. KDM1A knockdown (KD) or treatment with KDM1A inhibitors NCD38 and SP2509 sensitized established and patient-derived OCa cells to chemotherapy drugs in reducing cell viability and clonogenic survival and inducing apoptosis. Moreover, knockdown of KDM1A sensitized carboplatin-resistant A2780-CP70 cells to carboplatin treatment and paclitaxel-resistant SKOV3-TR cells to paclitaxel. RNA-seq analysis revealed that a combination of KDM1A-KD and cisplatin treatment resulted in the downregulation of genes related to epithelial-mesenchymal transition (EMT). Interestingly, cisplatin treatment increased a subset of NF-κB pathway genes, and KDM1A-KD or KDM1A inhibition reversed this effect. Importantly, KDM1A-KD, in combination with cisplatin, significantly reduced tumor growth compared to a single treatment in an orthotopic intrabursal OCa xenograft model. Collectively, these findings suggest that combination of KDM1A inhibitors with chemotherapy could be a promising therapeutic approach for the treatment of OCa.
Collapse
Affiliation(s)
- Yihong Chen
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jessica D Johnson
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Sridharan Jayamohan
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Yi He
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Prabhakar P Venkata
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Diksha Jamwal
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Salvador Alejo
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Yi Zou
- Greehey Children's Cancer Research Institute, UT Health San Antonio, San Antonio, Texas, USA
| | - Zhao Lai
- Greehey Children's Cancer Research Institute, UT Health San Antonio, San Antonio, Texas, USA
- Department of Molecular Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Suryavathi Viswanadhapalli
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
- Mays Cancer Center, UT Health San Antonio, San Antonio, Texas, USA
| | - Ratna K Vadlamudi
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
- Mays Cancer Center, UT Health San Antonio, San Antonio, Texas, USA
- Audie L. Murphy South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Edward Kost
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
| | - Gangadhara R Sareddy
- Department of Obstetrics and Gynecology, UT Health San Antonio, San Antonio, Texas, USA
- Mays Cancer Center, UT Health San Antonio, San Antonio, Texas, USA
| |
Collapse
|
32
|
Xu H, Wang L, Xu D. Global publication productivity and research trends on recurrent ovarian cancer: a bibliometric study. Front Oncol 2024; 14:1422213. [PMID: 39035742 PMCID: PMC11257877 DOI: 10.3389/fonc.2024.1422213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction Recurrent ovarian cancer (ROC) presents a dismal prognosis, persistently devoid of efficacious therapeutic strategies. Over the past decade, significant shifts have transpired in ROC management, marked by the identification of novel therapeutic targets and advancements in biomarker research and innovation. Since bibliometrics is an effective method for revealing scientific literature, we conducted a bibliometric analysis of literature pertaining to ROC. Our exploration encompassed identifying emerging research trends and common patterns, analyzing collaborative networks, and anticipating future directions within this clinical context. Methods We conducted a search in the Web of Science Core Collection (WoSCC) to acquire relevant articles as our dataset, which were then exported using R-Studio-2023.12.0-369 software. The Bibliometrix R package was utilized to perform visual analyses on countries, institutions, journals, authors, landmark articles, and keywords within this research field. Results A total of 1538 articles and 173 reviews published between 2014 and 2023 were eventually retrieved. The annual growth rate of scientific production was 4.27%. The USA led the way in the number of published works, total citations, and collaboration. Gynecologic Oncology was the most favoured journal in this research field. Vergote I from the University Hospital Leuven, was the most influential author. At last, the most prominent keywords were "chemotherapy" (n = 124), "bevacizumab" (n = 87), and "survival" (n = 65). Clinical outcomes (prognosis, survival), chemotherapy, bevacizumab, and PARP inhibitors (olaparib, niraparib) represented the basic and transversal themes, while antibody-drug conjugate (ADC) and drug resistance were emerging themes. Cytoreduction surgical procedures and tamoxifen were niche themes, while immunotherapy and biomarkers were motor themes and had high centrality. Conclusion The trends in the ROC research field over the past decade were revealed through bibliometric analysis. Platinum resistance, ADC, and immunotherapy have emerged as the current prominent research topics.
Collapse
Affiliation(s)
| | | | - Dianbo Xu
- Department of Gynecology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
33
|
Hua T, Liu DX, Zhang XC, Li ST, Wu JL, Zhao Q, Chen SB. Establishment of an ovarian cancer exhausted CD8+T cells-related genes model by integrated analysis of scRNA-seq and bulk RNA-seq. Eur J Med Res 2024; 29:358. [PMID: 38970067 PMCID: PMC11225302 DOI: 10.1186/s40001-024-01948-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 06/24/2024] [Indexed: 07/07/2024] Open
Abstract
Ovarian cancer (OC) was the fifth leading cause of cancer death and the deadliest gynecological cancer in women. This was largely attributed to its late diagnosis, high therapeutic resistance, and a dearth of effective treatments. Clinical and preclinical studies have revealed that tumor-infiltrating CD8+T cells often lost their effector function, the dysfunctional state of CD8+T cells was known as exhaustion. Our objective was to identify genes associated with exhausted CD8+T cells (CD8TEXGs) and their prognostic significance in OC. We downloaded the RNA-seq and clinical data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. CD8TEXGs were initially identified from single-cell RNA-seq (scRNA-seq) datasets, then univariate Cox regression, the least absolute shrinkage and selection operator (LASSO), and multivariate Cox regression were utilized to calculate risk score and to develop the CD8TEXGs risk signature. Kaplan-Meier analysis, univariate Cox regression, multivariate Cox regression, time-dependent receiver operating characteristics (ROC), nomogram, and calibration were conducted to verify and evaluate the risk signature. Gene set enrichment analyses (GSEA) in the risk groups were used to figure out the closely correlated pathways with the risk group. The role of risk score has been further explored in the homologous recombination repair deficiency (HRD), BRAC1/2 gene mutations and tumor mutation burden (TMB). A risk signature with 4 CD8TEXGs in OC was finally built in the TCGA database and further validated in large GEO cohorts. The signature also demonstrated broad applicability across various types of cancer in the pan-cancer analysis. The high-risk score was significantly associated with a worse prognosis and the risk score was proven to be an independent prognostic biomarker. The 1-, 3-, and 5-years ROC values, nomogram, calibration, and comparison with the previously published models confirmed the excellent prediction power of this model. The low-risk group patients tended to exhibit a higher HRD score, BRCA1/2 gene mutation ratio and TMB. The low-risk group patients were more sensitive to Poly-ADP-ribose polymerase inhibitors (PARPi). Our findings of the prognostic value of CD8TEXGs in prognosis and drug response provided valuable insights into the molecular mechanisms and clinical management of OC.
Collapse
Affiliation(s)
- Tian Hua
- Department of Gynecology, Affiliated Xingtai People Hospital of Hebei Medical University, Xingtai, China
| | - Deng-Xiang Liu
- Department of Oncology, Affiliated Xingtai People Hospital of Hebei Medical University, 16 Hongxing Road, Xingtai, Hebei, 054001, People's Republic of China
| | - Xiao-Chong Zhang
- Department of Oncology, Affiliated Xingtai People Hospital of Hebei Medical University, 16 Hongxing Road, Xingtai, Hebei, 054001, People's Republic of China
| | - Shao-Teng Li
- Department of Oncology, Affiliated Xingtai People Hospital of Hebei Medical University, 16 Hongxing Road, Xingtai, Hebei, 054001, People's Republic of China
| | - Jian-Lei Wu
- Department of Gynecological Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, Shandong, 250021, People's Republic of China
| | - Qun Zhao
- The Third Department of Surgery , Hebei Medical University, Fourth Hospital, Road Jiankang No. 12, Hebei, 050001, People's Republic of China.
- Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China.
| | - Shu-Bo Chen
- Department of Oncology, Affiliated Xingtai People Hospital of Hebei Medical University, 16 Hongxing Road, Xingtai, Hebei, 054001, People's Republic of China.
| |
Collapse
|
34
|
Lulli M, Trabocchi A, Roviello G, Catalano M, Papucci L, Parenti A, Molli A, Napoli C, Landini I, Schiavone N, Lapucci A. Targeting z-Crystallin by aspirin restores the sensitivity to cisplatin in resistant A2780 ovarian cancer cells. Front Pharmacol 2024; 15:1377028. [PMID: 39021835 PMCID: PMC11252033 DOI: 10.3389/fphar.2024.1377028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/16/2024] [Indexed: 07/20/2024] Open
Abstract
Ovarian cancer is the deadliest gynaecologic malignancies worldwide. Platinum based chemotherapy is the mainstay treatment for ovarian cancer; however, frequent recurrence and chemoresistance onset in patients with advanced diseases remain a therapeutic challenge. Although mechanisms underlying the development of chemoresistance are still ambiguous, the B-cell lymphoma-2 (Bcl-2) family is closely associated with chemoresistance in ovarian cancer. We previously disclosed that Zeta-Crystallin (CryZ) is a post-transcriptional regulator of Bcl-2 gene expression, by binding to Bcl-2 mRNA and increasing its half-life. Here, we investigated the role of CryZ as a novel therapeutic target in A2780 ovarian carcinoma cells by modulating the protein activity with acetylsalicylic acid (ASA) to restore chemosensitivity. Molecular docking and fragment-mapping based approach revealed potential interaction of ASA within CryZ protein. Inhibition of CryZ binding activity to Bcl-2 and Bcl-xl mRNA targets by ASA was demonstrated in A375 cells. Cytotoxicity assays were conducted in A2780S and A2780R ovarian cancer cells to evaluate if CryZ binding activity inhibition and CryZ silencing were able to reverse cisplatin resistance. ASA-treatment determined a downregulation of Bcl-2 and Bcl-xl mRNA levels in A2780S and A2780R cells. ASA-treatment or CryZ silencing were able to increase and restore the chemosensitivity in both sensitive and resistant A2780 ovarian cancer cells, respectively. In this research article we demonstrated that the pharmacological or genetic inhibition of CryZ restores the sensitivity to cisplatin in a model of sensitive or resistant ovarian cancer cells. These findings suggest a new gene-targeted chemotherapeutic approach to restore the cytotoxicity in drug-resistant ovarian cancers and increase the sensitivity in non-resistant cells.
Collapse
Affiliation(s)
- Matteo Lulli
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Andrea Trabocchi
- Department of Chemistry “Ugo Schiff”, University of Florence, Florence, Italy
| | - Giandomenico Roviello
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Martina Catalano
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Laura Papucci
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Astrid Parenti
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Alice Molli
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Cristina Napoli
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Ida Landini
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| | - Nicola Schiavone
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, Section of Experimental Pathology and Oncology, University of Florence, Florence, Italy
| | - Andrea Lapucci
- Department of Health Sciences, Section of Clinical Pharmacology and Oncology, University of Florence, Florence, Italy
| |
Collapse
|
35
|
Foresta A, Capomacchia FM, Certelli C, Caricato C, Fagotti A, Scambia G, Gallotta V. Robotic staging for early ovarian cancer in 10 steps. Int J Gynecol Cancer 2024:ijgc-2023-005135. [PMID: 38955377 DOI: 10.1136/ijgc-2023-005135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024] Open
Affiliation(s)
- Aniello Foresta
- Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Camilla Certelli
- Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Chiara Caricato
- Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Anna Fagotti
- Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
- Department of Women's, Children's and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Institute of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
- Department of Women's, Children's and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Valerio Gallotta
- Department of Women's, Children's and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| |
Collapse
|
36
|
Graybill WS, Pardo Búrdalo B, O'Malley DM, Vergote I, Monk BJ, Auranen A, Copeland LJ, Sabbatini R, Herzog TJ, Follana P, Pothuri B, Braicu EI, McCormick C, Yubero A, Moore RG, Vuylsteke P, Raaschou-Jensen N, York W, Hartman J, González-Martín A. Predictors of long-term progression-free survival in patients with ovarian cancer treated with niraparib in the PRIMA/ENGOT-OV26/GOG-3012 study. Int J Gynecol Cancer 2024; 34:1041-1050. [PMID: 38950925 PMCID: PMC11228198 DOI: 10.1136/ijgc-2024-005356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/19/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVE To identify characteristics associated with long-term progression-free survival (≥2 years) in patients with advanced ovarian cancer treated with niraparib first-line maintenance therapy in the phase III PRIMA/ENGOT-OV26/GOG-3012 study. METHODS In this post hoc analysis of PRIMA, patients randomized to niraparib were grouped based on investigator-assessed progression-free survival (progressive disease/censoring <2 years or ≥2 years after randomization). Variables assessed for predictive value were Eastern Cooperative Oncology Group performance status, International Federation of Gynecology and Obstetrics (FIGO) stage at diagnosis, clinical response to platinum-based chemotherapy, number of prior chemotherapy cycles, primary tumor location, body mass index, categorical age, debulking surgery type, number of baseline target lesions, number of baseline non-target lesions, BRCA/homologous recombination-deficiency status, residual disease status, and duration from end of chemotherapy to randomization. Logistic regression modeling using backward elimination (significance level=0.15) identified covariates associated with long-term progression-free survival (clinical cut-off date November 17, 2021). RESULTS Of 487 patients randomized to niraparib, 152 (31%) had progressive disease/censoring ≥2 years after randomization. Multivariable logistic regression modeling using backward elimination identified BRCA1/2 mutation/homologous recombination deficiency status (p<0.0001), FIGO stage (p=0.041), primary tumor location (p=0.095), and number of baseline non-target lesions (p=0.0001) to be associated with long-term progression-free survival. Patients significantly more likely to achieve progression-free survival of ≥2 years in the final model were those with BRCA1- and BRCA2-mutated/homologous recombination-deficient tumors or BRCA wild-type/not determined/homologous recombination-deficient tumors (vs BRCA wild-type/homologous recombination-proficient/not determined tumors), FIGO stage III (vs IV), and 0 or 1 baseline non-target lesions (vs ≥2 baseline non-target lesions). CONCLUSIONS The hypothesis-generating results of this analysis suggest that BRCA1/2 mutation/homologous recombination-deficiency status, FIGO stage, and number of baseline non-target lesions may predict progression-free survival of ≥2 years in patients with advanced ovarian cancer receiving niraparib first-line maintenance therapy. TRIAL REGISTRATION NUMBER NCT02655016.
Collapse
Affiliation(s)
| | - Beatriz Pardo Búrdalo
- Medical Oncology Department, Institut Català d'Oncologia L'Hospitalet de Llobregat, Hospital Duran i Reynals, IDIBELL, and Grupo Español de Investigación en Cancer ginecológicO (GEICO), Barcelona, Spain
| | - David M O'Malley
- Division of Gynecologic Oncology, The Ohio State University and the James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Ignace Vergote
- Gynecological Oncology, University Hospitals Leuven, and Belgium and Luxembourg Gynaecological Oncology Group (BGOG), Leuven, Belgium
| | - Bradley J Monk
- The GOG Foundation Inc (GOG-F) and Florida Cancer Specialists and Research Institute, West Palm Beach, Florida, USA
| | - Annika Auranen
- Tampere University Hospital, Tays Cancer Centre and Nordic Society of Gynaecological Oncology (NSGO), Tampere, Finland
| | - Larry J Copeland
- Division of Gynecologic Oncology, The Ohio State University and the James Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Roberto Sabbatini
- AOU Policlinico di Modena, and Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Modena, Italy
| | - Thomas J Herzog
- University of Cincinnati Cancer Center, Department of Obstetrics & Gynecology, College of Medicine, Cincinnati, Ohio, USA
| | - Philippe Follana
- Centre Antoine Lacassagne and Groupe d'Investigateurs Nationaux pour l'Etude des Cancers de l'Ovaire et du Sein (GINECO), Nice, France
| | - Bhavana Pothuri
- GOG-F and Departments of Obstetrics/Gynecology and Medicine, Division of Gynecologic Oncology, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Elena Ioana Braicu
- Charité Universitätsmedizin and Arbeitsgemeinschaft Gynäkologische Onkologie (AGO), Berlin, Germany
| | | | - Alfonso Yubero
- Hospital Clínico Universitario Lozano Blesa and GEICO, Zaragoza, Spain
| | - Richard G Moore
- Department of Obstetrics and Gynecology, Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA
| | - Peter Vuylsteke
- CHU UCL Namur (Sainte-Elisabeth), Namur, Belgium, and University of Botswana, Gaborone, Botswana
| | | | | | | | - Antonio González-Martín
- Medical Oncology Department, Cancer Center Clínica Universidad de Navarra, Madrid, and Program in Solid Tumours, CIMA, Pamplona, and GEICO, Madrid, Spain
| |
Collapse
|
37
|
González-Martín A, Chung HC, Saada-Bouzid E, Yanez E, Senellart H, Cassier PA, Basu B, Corr BR, Girda E, Dutcus C, Okpara CE, Ghori R, Jin F, Groisberg R, Lwin Z. Lenvatinib plus pembrolizumab for patients with previously treated advanced ovarian cancer: Results from the phase 2 multicohort LEAP-005 study. Gynecol Oncol 2024; 186:182-190. [PMID: 38718741 DOI: 10.1016/j.ygyno.2024.04.011] [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: 01/25/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES The phase 2, multicohort, open-label LEAP-005 study evaluated lenvatinib plus pembrolizumab in patients with previously treated advanced solid tumors. We report outcomes from the ovarian cancer cohort. METHODS Eligible patients had metastatic/unresectable ovarian cancer and had received 3 previous lines of therapy. Patients received lenvatinib 20 mg/day plus pembrolizumab 200 mg every 3 weeks. Treatment continued until progression, unacceptable toxicity, or (for pembrolizumab) completion of 35 cycles. Primary endpoints were objective response rate (ORR) per RECIST version 1.1 and safety. Secondary endpoints included duration of response (DOR), progression-free survival (PFS), and overall survival (OS). RESULTS Thirty-one patients were enrolled. 39% had high grade serous ovarian cancer, 23% were platinum-sensitive, 55% were platinum-resistant, 23% were platinum-refractory, and 84% had tumors that had a PD-L1 combined positive (CPS) score ≥1. ORR (95% CI) was 26% (12%-45%) by investigator assessment and 35% (19%-55%) by blinded independent central review (BICR). Per BICR, median DOR was 9.2 (1.5+ to 37.8+) months. ORRs (95% CI) by BICR were 35% (9/26 patients; 17%-56%) for PD-L1 CPS ≥ 1 disease and 50% (2/4 patients; 7%-93%) for PD-L1 CPS < 1 disease. Median (95% CI) PFS by BICR and OS were 6.2 (4.0-8.5) months and 21.3 (11.7-32.3) months, respectively. Treatment-related AEs occurred in 94% of patients (grade 3-4, 77%). One patient died from treatment-related hypovolemic shock. CONCLUSIONS Lenvatinib plus pembrolizumab demonstrated antitumor activity as fourth line therapy in patients with advanced ovarian cancer, and no unanticipated safety signals were identified. Responses were observed regardless of PD-L1 status.
Collapse
Affiliation(s)
- Antonio González-Martín
- Department of Medical Oncology, Cancer Center Clinica Universidad de Navarra, Madrid, Spain.
| | - Hyun Cheol Chung
- Department of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France.
| | - Eduardo Yanez
- Oncology-Hematology Unit, University of Frontera, Araucanía, Chile.
| | | | | | - Bristi Basu
- Cancer Research UK Cambridge Centre, University of Cambridge, Cambridge, UK.
| | | | - Eugenia Girda
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
| | | | | | | | - Fan Jin
- Merck & Co., Inc., Rahway, NJ, USA.
| | | | - Zarnie Lwin
- Royal Brisbane and Women's Hospital and University of Queensland, Herston, Queensland, Australia.
| |
Collapse
|
38
|
Gonzalez A, Nagel CI, Haight PJ. Targeted Therapies in Low-Grade Serous Ovarian Cancers. Curr Treat Options Oncol 2024; 25:854-868. [PMID: 38869696 PMCID: PMC11236859 DOI: 10.1007/s11864-024-01205-4] [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] [Accepted: 04/11/2024] [Indexed: 06/14/2024]
Abstract
OPINION STATEMENT Low grade serous carcinoma of the ovary has been delineated as a separate entity from its counterpart high grade serous carcinoma of the ovary. Molecular profiling has helped to further characterize this disease process and has led to new and exciting treatment options. Surgery has always been a cornerstone of management both in primary and recurrent disease settings. Chemotherapy has been a long-standing backbone of adjuvant treatment, but its efficacy continues to be questioned. Hormonal therapy for upfront and recurrent disease is an effective treatment option with a high response rate and minimal side effects. Newer therapies including MEK, CDK 4/6, and PI3KCA inhibitors have emerged as exciting options for recurrent disease. Ongoing clinical trials will hopefully lead to additional therapeutic opportunities based on novel biomarkers in this disease.
Collapse
Affiliation(s)
- Anna Gonzalez
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, M-210 Starling Loving Hall, 320 W. 10th Avenue, Columbus, OH, 43210, USA
| | - Christa I Nagel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, M-210 Starling Loving Hall, 320 W. 10th Avenue, Columbus, OH, 43210, USA.
| | - Paulina J Haight
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, James Hospital and Solove Research Institute, M-210 Starling Loving Hall, 320 W. 10th Avenue, Columbus, OH, 43210, USA
| |
Collapse
|
39
|
Zhao Y, Yuan H, Chen Y, Yao H, Li N, Wu L, Yuan G. Outcomes of secondary cytoreductive surgery in patients with platinum-sensitive recurrent ovarian cancer progressed after prior poly (adenosine diphosphate-ribose) polymerase inhibitors: A retrospective cohort study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108383. [PMID: 38704898 DOI: 10.1016/j.ejso.2024.108383] [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: 03/04/2024] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To evaluate the impact of previous poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitor therapy on the effectiveness of secondary cytoreductive surgery (SCS) in patients with platinum-sensitive recurrent ovarian cancer (PSROC). METHODS We identified patients with PSROC who underwent SCS at the Cancer Hospital, Chinese Academy of Medical Science, between January 2010 and December 2022. Postoperative complications within 30 days were categorized using the Accordion Severity Grading System. The Kaplan‒Meier method was used to estimate both overall survival (OS) and progression-free survival (PFS), and multivariate analysis was used to identify independent prognostic factors. RESULTS Of the 265 patients included, 39 received prior PARP inhibitor therapy (Group A), and 226 did not (Group B). The rates of complete resection after SCS did not significantly differ between the two groups (79.5 % for Group A vs. 81.0 % for Group B; p = 0.766). As of December 2023, Group A exhibited a significantly shorter median PFS (14.2 months) than Group B (22.5 months; p = 0.002). Furthermore, the 3-year OS rate was lower in Group A (72.5 %) than in Group B (82.7 %; p = 0.015). The incidence of severe postoperative complications was comparable between Groups A and B (7.7 % vs. 1.8 %; p = 0.061). Multivariate analysis revealed that prior PARP inhibitor therapy significantly reduced the median PFS (hazard ratio (HR) = 4.434; p = 0.021) and OS (HR = 2.076; p = 0.010). CONCLUSIONS SCS for PSROC demonstrated reduced efficacy in patients previously treated with PARP inhibitors compared to those without prior PARP inhibitor treatment.
Collapse
Affiliation(s)
- Yuxi Zhao
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hua Yuan
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yiran Chen
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hongwen Yao
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Ning Li
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Lingying Wu
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Guangwen Yuan
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| |
Collapse
|
40
|
Yang EJ, Lee AJ, Hwang WY, Chang SJ, Kim HS, Kim NK, Kim Y, Kong TW, Lee EJ, Park SJ, Son JH, Suh DH, Son DH, Shim SH. Lymphadenectomy in clinically early epithelial ovarian cancer and survival analysis (LILAC): a Gynecologic Oncology Research Investigators Collaboration (GORILLA-3002) retrospective study. J Gynecol Oncol 2024; 35:e75. [PMID: 38497109 PMCID: PMC11262888 DOI: 10.3802/jgo.2024.35.e75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 02/13/2024] [Accepted: 02/25/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVE This study aimed to evaluate the therapeutic role of lymphadenectomy in patients surgically treated for clinically early-stage epithelial ovarian cancer (EOC). METHODS This retrospective, multicenter study included patients with clinically early-stage EOC based on preoperative abdominal-pelvic computed tomography or magnetic resonance imaging findings between 2007 and 2021. Oncologic outcomes and perioperative complications were compared between the lymphadenectomy and non-lymphadenectomy groups. Independent prognostic factors were determined using Cox regression analysis. Disease-free survival (DFS) was the primary outcome. Overall survival (OS) and perioperative outcomes were the secondary outcomes. RESULTS In total, 586 patients (lymphadenectomy group, n=453 [77.3%]; non-lymphadenectomy groups, n=133 [22.7%]) were eligible. After surgical staging, upstaging was identified based on the presence of lymph node metastasis in 14 (3.1%) of 453 patients. No significant difference was found in the 5-year DFS (88.9% vs. 83.4%, p=0.203) and 5-year OS (97.2% vs. 97.7%, p=0.895) between the two groups. Using multivariable analysis, lymphadenectomy was not significantly associated with DFS or OS. However, using subgroup analysis, the lymphadenectomy group with serous histology had higher 5-year DFS rates than did the non-lymphadenectomy group (86.5% vs. 74.4%, p=0.048; adjusted hazard ratio=0.281; 95% confidence interval=0.107-0.735; p=0.010). The lymphadenectomy group had longer operating time (p<0.001), higher estimated blood loss (p<0.001), and higher perioperative complication rate (p=0.004) than did the non-lymphadenectomy group. CONCLUSION In patients with clinically early-stage EOC with serous histology, lymphadenectomy was associated with survival benefits. Considering its potential harm, lymphadenectomy should be performed according to histologic subtype and subsequent chemotherapy in patients with clinically early-stage EOC. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0007309.
Collapse
Affiliation(s)
- Eun Jung Yang
- Department of Obstetrics and Gynecology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - A Jin Lee
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Woo Yeon Hwang
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Suk-Joon Chang
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Hee Seung Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Nam Kyeong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yeorae Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Wook Kong
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Eun Ji Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Jin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Joo-Hyuk Son
- Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Hee Son
- Research Coordinating Center, Konkok University Medical Center, Seoul, Korea
| | - Seung-Hyuk Shim
- Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.
| |
Collapse
|
41
|
Olawaiye AB, Kim JW, Bagameri A, Bishop E, Chudecka-Głaz A, Devaux A, Gladieff L, Gordinier ME, Korach J, McCollum ME, Mileshkin L, Monk BJ, Nicum S, Nogueira-Rodrigues A, Oaknin A, O'Malley DM, Orlando M, Dreiling L, Tudor IC, Lorusso D. Clinical Trial Protocol for ROSELLA: a phase 3 study of relacorilant in combination with nab-paclitaxel versus nab-paclitaxel monotherapy in advanced platinum-resistant ovarian cancer. J Gynecol Oncol 2024; 35:e111. [PMID: 39032926 PMCID: PMC11262895 DOI: 10.3802/jgo.2024.35.e111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 06/11/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Ovarian cancer has the highest mortality among gynecologic cancers, primarily because it typically is diagnosed at a late stage and because of the development of chemoresistance in recurrent disease. Improving outcomes in women with platinum-resistant ovarian cancer is a substantial unmet need. Activation of the glucocorticoid receptor (GR) by cortisol has been shown to suppress the apoptotic pathways used by cytotoxic agents, limiting their efficacy. Selective GR modulation may be able to counteract cortisol's antiapoptotic effects, enhancing chemotherapy's efficacy. A previous phase 2 study has shown that adding intermittently dosed relacorilant, a selective GR modulator, to nab-paclitaxel improved outcomes, including progression-free survival (PFS) and overall survival (OS), with minimal added toxicity, in women with recurrent platinum-resistant ovarian cancer. The ROSELLA study aims to confirm and expand on these findings in a larger population. METHODS ROSELLA is a phase 3, randomized, 2-arm, open-label, global multicenter study in women with recurrent, platinum-resistant, high-grade serous epithelial ovarian, primary peritoneal, or fallopian tube cancer. Eligible participants have received 1 to 3 lines of prior systemic anticancer therapy, including ≥1 prior line of platinum therapy and prior treatment with bevacizumab, with documented progressive disease or intolerance to the most recent therapy. There is no biomarker-based requirement for participant selection. Participants are randomized 1:1 to receive intermittently dosed relacorilant in combination with nab-paclitaxel or nab-paclitaxel monotherapy. The study's primary efficacy endpoint is PFS as assessed by blinded independent central review. Secondary efficacy endpoints include OS, investigator-assessed PFS, objective response rate, best overall response, duration of response, clinical benefit rate at 24 weeks, and cancer antigen 125 response. The study is also evaluating safety and patient-reported outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05257408; European Union Drug Regulating Authorities Clinical Trials Database Identifier: 2022-000662-18.
Collapse
Affiliation(s)
- Alexander B Olawaiye
- University of Pittsburgh School of Medicine and Magee-Womens Hospital, Gynecologic Oncology Group, Pittsburgh, PA, USA.
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University, Seoul, Korea
| | | | - Erin Bishop
- Medical College of Wisconsin, Gynecologic Oncology Group, Milwaukee, WI, USA
| | - Anita Chudecka-Głaz
- Pomeranian Medical University, Polish Gynecologic Oncology Group, Szczecin, Poland
| | - Alix Devaux
- Oncology Department of Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Laurence Gladieff
- Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse Oncopole, Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Toulouse, France
| | | | - Jacob Korach
- Sheba Medical Center, School of Medicine, Tel Aviv University, Israeli Society of Gynecologic Oncology, Tel Aviv, Israel
| | | | - Linda Mileshkin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Bradley J Monk
- Gynecologic Oncology Group Foundation; Florida Cancer Specialists and Research Institute, West Palm Beach, FL, USA
| | - Shibani Nicum
- University College London Cancer Institute, National Cancer Research Institute, London, UK
| | | | - Ana Oaknin
- Medical Oncology Service, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - David M O'Malley
- The Ohio State University and the James Cancer Center, Gynecologic Oncology Group, Columbus, OH, USA
| | - Mauro Orlando
- Instituto Alexander Fleming, Buenos Aires, Argentina
| | | | - Iulia C Tudor
- Corcept Therapeutics Incorporated, Menlo Park, CA, USA
| | - Domenica Lorusso
- Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico and Catholic University of the Sacred Heart, Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies, Rome, Italy
| |
Collapse
|
42
|
Pappa C, Galaal K, Smyth S, Bristow RE, Khashan AS, Alazzam M. Cytoreductive surgery plus chemotherapy versus chemotherapy alone for recurrent epithelial ovarian cancer. Cochrane Database Syst Rev 2024; 6:CD015297. [PMID: 38934360 PMCID: PMC11209860 DOI: 10.1002/14651858.cd015297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the benefits and harms of secondary CRS and chemotherapy in comparison to chemotherapy alone for women with platinum-sensitive recurrent epithelial ovarian cancer.
Collapse
Affiliation(s)
- Christina Pappa
- Gynaecological Oncology Division, Oxford University Hospitals, Oxford, UK
| | - Khadra Galaal
- Surgical Oncology Department, Sultan Qaboos Comprehensive Cancer Centre SQCCCRC, Muscat, Oman
| | - Sarah Smyth
- Gynaecological Oncology Division, Oxford University Hospitals, Oxford, UK
| | - Robert E Bristow
- Division of Gynecologic Oncology, University of California - Irvine, Medical Center, Orange, CA, USA
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
| | - Mo'iad Alazzam
- Gynaecological Oncology Division, Oxford University Hospitals, Oxford, UK
| |
Collapse
|
43
|
Guan Z, Zhang C, Lin X, Zhang J, Li T, Li J. Oncological outcomes of fertility-sparing surgery versus radical surgery in stage - epithelial ovarian cancer: a systematic review and meta-analysis. World J Surg Oncol 2024; 22:170. [PMID: 38918840 PMCID: PMC11201297 DOI: 10.1186/s12957-024-03440-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 06/16/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The oncological outcomes of fertility-sparing surgery (FSS) compared to radical surgery (RS) in patients with stage I epithelial ovarian cancer (EOC) remain a subject of debate. We evaluated the risk ratios (RRs) for outcomes in patients with stage I EOC who underwent FSS versus RS. METHODS We conducted a systematic search of PubMed, Web of Science, and Embase for articles published up to November 29, 2023. Studies that did not involve surgical procedures or included pregnant patients were excluded. We calculated the RRs for disease-free survival, overall survival, and recurrence rate. The quality of the included studies was assessed using the Cochrane Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. The meta-analysis was registered on PROSPERO (CRD42024546460). RESULTS From the 5,529 potentially relevant articles, we identified 83 articles for initial screening and included 12 articles in the final meta-analysis, encompassing 2,906 patients with epithelial ovarian cancer. There were no significant differences between the two groups in disease-free survival (RR [95% confidence interval {CI}], 0.90 [0.51, 1.58]; P = 0.71), overall survival (RR [95% CI], 0.74 [0.53, 1.03]; P = 0.07), and recurrence rate (RR [95% CI], 1.10 [0.69, 1.76]; P = 0.68). In sensitivity analyses, the significant difference was observed only for overall survival (before exclusion: RR [95% CI], 0.74 [0.53-1.03], P = 0.07; after exclusion: RR [95% CI], 0.70 [0.50-0.99]; P = 0.04). CONCLUSIONS This is the first and only individual patient data meta-analysis comparing disease-free survival, overall survival, and recurrence rate of patients with early-stage epithelial ovarian cancer undergoing FSS and RS. FSS was associated with similar disease-free survival and risk of recurrence as RS. We hypothesized that the decreased overall survival in the FSS group could not be attributed to distant metastases from epithelial ovarian cancer.
Collapse
Affiliation(s)
- Ziting Guan
- Department of Gynecology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Changlin Zhang
- Department of Gynecology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Xinmei Lin
- Department of Gynecology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Jingwei Zhang
- Department of Gynecology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Tian Li
- Department of Gynecology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.
| | - Jundong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.
- Department of Gynecological Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
| |
Collapse
|
44
|
Herzog M, Verdenik I, Kobal B, Černe K. Higher EpCAM-Positive Extracellular Vesicle Concentration in Ascites Is Associated with Shorter Progression-Free Survival of Patients with Advanced High-Grade Serous Carcinoma. Int J Mol Sci 2024; 25:6780. [PMID: 38928484 PMCID: PMC11204144 DOI: 10.3390/ijms25126780] [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: 04/26/2024] [Revised: 06/10/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Platinum-resistant high-grade serous carcinoma (HGSC) is an incurable disease, so biomarkers that could help with timely treatment adjustments and personalized approach are extensively being sought. Tumor-derived extracellular vesicles (EVs) that can be isolated from ascites and blood of HGSC patients are such promising biomarkers. Epithelial cell adhesion molecule (EpCAM) expression is upregulated in most epithelium-derived tumors; however, studies on prognostic value of EpCAM overexpression in ovarian carcinoma have shown contradictory results. The aim of our study was to evaluate the potential of total and EpCAM-positive EVs as prognostic and predictive biomarkers for advanced HGSC. Flow cytometry was used to determine the concentration of total and EpCAM-positive EVs in paired pretreatment ascites and plasma samples of 37 patients with advanced HGSC who underwent different first-line therapy. We found that higher EpCAM-positive EVs concentration in ascites is associated with shorter progression-free survival (PFS) regardless of treatment strategy. We also found a strong correlation of EpCAM-positive EVs concentration between ascites and plasma. Our findings indicate that EpCAM-positive EVs in ascites of patients with advanced HGSC have the potential to serve as prognostic biomarkers for predicting early recurrence and thereby likelihood of more aggressive tumor biology and development of chemoresistance.
Collapse
Affiliation(s)
- Maruša Herzog
- Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia; (M.H.); (I.V.); (B.K.)
| | - Ivan Verdenik
- Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia; (M.H.); (I.V.); (B.K.)
| | - Borut Kobal
- Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, SI-1000 Ljubljana, Slovenia; (M.H.); (I.V.); (B.K.)
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| | - Katarina Černe
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Ljubljana, SI-1000 Ljubljana, Slovenia
| |
Collapse
|
45
|
Trevisi E, Sessa C, Colombo I. Clinical relevance of circulating tumor DNA in ovarian cancer: current issues and future opportunities. EXPLORATION OF TARGETED ANTI-TUMOR THERAPY 2024; 5:627-640. [PMID: 38966171 PMCID: PMC11220313 DOI: 10.37349/etat.2024.00239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/13/2024] [Indexed: 07/06/2024] Open
Abstract
Ovarian cancer (OC) is the most lethal gynecologic malignancy worldwide. Due to the lack of effective screening and early detection strategies, many patients with OC are diagnosed with advanced disease, where treatment is rarely curative. Moreover, OC is characterized by high intratumor heterogeneity, which represents a major barrier to the development of effective treatments. Conventional tumor biopsy and blood-based biomarkers, such as cancer antigen 125 (CA125), have different limitations. Liquid biopsy has recently emerged as an attractive and promising area of investigation in oncology, due to its minimally invasive, safe, comprehensive, and real-time dynamic nature. Preliminary evidence suggests a potential role of liquid biopsy to refine OC management, by improving screening, early diagnosis, assessment of response to treatment, detection, and profiling of drug resistance. The current knowledge and the potential clinical value of liquid biopsy in OC is discussed in this review to provide an overview of the clinical settings in which its use might support and improve diagnosis and treatment.
Collapse
Affiliation(s)
- Elena Trevisi
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
| | - Cristiana Sessa
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
| | - Ilaria Colombo
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
| |
Collapse
|
46
|
Pierre ME, Manneh R, Hernández A, Rodríguez J, Fletcher AV, Ramírez HM, Niño OM, Gómez DA, Sanabria D, Contreras F, Pieschacón JR, Calderón PH. Expert consensus: Profiling and management of advanced or metastatic epithelial ovarian cancer. REVISTA COLOMBIANA DE OBSTETRICIA Y GINECOLOGIA 2024; 75:4094. [PMID: 39013199 PMCID: PMC11210286 DOI: 10.18597/rcog.4094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 04/30/2024] [Indexed: 07/18/2024]
Abstract
Introduction and objective: The approach to patients with advanced or metastatic high-grade epithelial ovarian cancer (EOC) has evolved over time with the advent of new therapies and multimodal strategies. The objective of this consensus of experts is to generate national recommendations for the profiling and management of advanced or metastatic high-grade OEC, defined as stages III and IV of the “The International Federation of Gynecology and Obstetrics (FIGO) classification at the time of diagnosis to base on the literature review that included international evidence-based clinical practice guidelines (CPG). Material and methods: Eleven panelists (oncologists and gynecological oncologists) answered 8 questions about the profiling and management of advanced or metastatic ovarian epithelial carcinoma. The panelists were chosen for their academic profile and influence in national health institutions. Guidelines from the “ESMO Standardized Operating Procedures Consensus Conference” were used to develop the consensus. It was agreed that the level of agreement to accept a recommendation should be ≥ 80%. The document was peer reviewed. Results: Eight general recommendations are made, which are presented into five domains. Some of these recommendations are subdivided into specific recommendations. Initial treatment Recommendation 1.1 Complete primary cytoreduction (PCS) surgery is suggested as the initial therapy of choice for patients with high-grade or metastatic EOC, which should ideally be carried out in centers with experience, followed by adjuvant therapy. 1.2 Neoadjuvant chemotherapy followed by interval cytoreduction surgery (ICS) is suggested in those who are unlikely to achieve a complete cytoreduction in PCS either due to unresectable metastatic disease or who present unresectability criteria (imaging, laparoscopic and/or by laparotomy) and that have been defined by a gynecological oncologist and patients with poor functional status and comorbidities according to the criteria of the multidisciplinary team (clinical oncology, gynecological oncology, radiology, etc.). Recommendation 2. In patients with high-grade epithelial ovarian cancer (EOC), in stage III locally advanced or metastatic, who received neoadjuvant chemotherapy and achieved a complete or partial response (cytoreduction with tumor residue < 2.5 mm), the use of Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) could be considered as an alternative to standard platinum-based adjuvant intravenous chemotherapy during interval cytoreductive surgery, after discussion in a multidisciplinary tumor board, at a center experienced in treating this type of patients. Use of genetic testing. Recommendation 3. It is suggested at the time of diagnosis to offer molecular genetic testing to all patients with high-grade advanced or metastatic EOC regardless of family history. Recommendation 4. It is suggested to offer genetic counseling, by qualified personnel, to all patients with high-grade advanced or metastatic EOC who are ordered genetic testing. Recommendation 5. It is suggested that all patients with advanced or metastatic high-grade EOC undergo a germ panel that includes the Breast Cancer Susceptibility Genes 1/2 genes (BRCA 1/2) and the other susceptibility genes according to with institutional protocols and the availability of genetic testing panels; If it is negative, then somatic testing should be performed that includes the homologous recombination deficiency (HRD) status, regardless of family history. Adjuvant Therapy Recommendation 6. 6.1. It is suggested that all patients with advanced stage III/IV EOC, with PSC of (0-2), got adjuvant intravenous chemotherapy as standard treatment within six weeks after Prc. It is suggested paclitaxel/carboplatin. Recommendation 6.2. It is suggested to use standard chemotherapy base on platinum plus Bevacizumab as adjuvant chemotherapy to patients with high-risk disease (EOC stage IV or stage III with suboptimal tumor cytoreduction), following by bevacizumab as maintenance. The use of bevacizumab as maintenance therapy is not recommended if bevacizumab was not included in the first line of treatment. We suggested the dose used in GOG-0218 and ICON7 trials. Recommendation 6.3 It is suggested combined intravenous/intraperitoneal chemotherapy only for selected patients, with optimal cytoreduction (residual lesions < 1 cm), especially those without residual disease (R0) and who are evaluated in a multidisciplinary meeting. It is not considered standard treatment. Recommendation 6.4. 6.4.1 It is suggested to use Poly ADP ribose polymerase (PARP) inhibitors such as olaparib or niraparib as maintenance after receiving first-line chemotherapy in patients with stage III/IV BRCA1/2 positive EOC who received platinumbased chemotherapy and obtained complete response/partial response (CR/PR), 6.4.2 It is suggested to use olaparib alone or in combination with bevacizumab or niraparib in patients with stage III/IV BRCA1/2 positive EOC who received platinum-based chemotherapy plus bevacizumab and achieved CR/PR. 6.4.3 It is suggested to use niraparibin patients with stage III/IV BRCA1/2 negative or unknown EOC who received platinum-based chemotherapy and achieved CR/PR. 6.4.4 It is suggested to use bevacizumab or olaparib plus bevacizumab in patients with EOC stage III/IV BRCA1/2 negative or unknown (HRD positive) who received platinum-based chemotherapy plus bevacizumab and obtained CR/PR. Treatment of disease relapse Recommendation 7. Secondary cytoreductive surgery followed by chemotherapy is suggested for selected patients with high-grade advanced EOC in first relapse, platinum-sensitive (platinum-free interval ≥ 6 months), positive “Arbeitsgemeinschaft Gynäkologische Onkologie – AGO” score or “I-model” positive (< 4.7) with a potential resection to R0 in centers with access to optimal surgical and postoperative support. Note: Platinum-free interval and AGO score have only been developed as positive predictors of complete resection and not to exclude patients from surgery. Recommendation 8. 8.1 For patients with relapse advanced high-grade EOC platinum-sensitive, the following is suggested: Platinum-based combination chemotherapy: carboplatin/liposomal doxorubicin or carboplatin/paclitaxel or carboplatin/nab-paclitaxel or carboplatin/docetaxel or carboplatin/gemcitabine) for six cycles. If combination therapy is not tolerated, give carboplatin or cisplatin alone. Combination chemotherapy (carboplatin/gemcitabine or carboplatin/paclitaxel or carboplatin/doxorubicin liposomal) plus bevacizumab followed by bevacizumab as maintenance (until progression or toxicity). Recommendation 8.2 For patients with relapsed advanced high-grade EOC platinum-resistant, it is suggested: Sequential treatment with chemotherapy, preferably with a non-platinum single agent (weekly paclitaxel or pegylated liposomal doxorubicin or docetaxel or oral etoposide or gemcitabine or trabectidine or, topotecan). Weekly paclitaxel or pegylated liposomal doxorubicin or topotecan could be administrate with or without bevacizumab. Other agents are considered potentially active (capecitabine, cyclophosphamide, ifosfamide, irinotecan, oxaliplatin, pemetrexed, vinorelbine, cyclophosphamide) could be recommended for later lines. Hormone receptor-positive patients who do not tolerate or have no response to cytotoxic regimens may receive hormone therapy with tamoxifen or other agents, including aromatase inhibitors (anastrozole and letrozole) or leuprolide acetate, or megestrol acetate. Patients with a performance score ≥ 3 should be considered only for best supportive care. Recommendation 8.3 Maintenance therapy with PARP inhibitors: It is suggested in patients with relapse advanced high-grade EOC stage III/IV BRCA1/2 (positive, negative or unknown) who have received two or more lines of platinum-based chemotherapy and have achieved CR/PR, use olaparib, niraparib or rucaparib. Niraparib could be useful in BRCA 1/2 +/-/unknown patients, as rucaparib, however, the latter does not yet have approval from the regulatory office in Colombia. Conclusions: It is expected that the recommendations issued in this consensus will contribute to improving clinical care, oncological impact, and quality of life of these women.
Collapse
Affiliation(s)
- Marc E. Pierre
- Centro de tratamiento e investigación sobre el Cáncer Luis Carlos Sarmiento (CTIC), Bogotá, Colombia, ,Centro de tratamiento e investigación sobre el Cáncer Luis Carlos Sarmiento (CTIC)BogotáColombia
| | - Ray Manneh
- Sociedad de Oncología y Hematología del Cesar, Valledupar, Colombia, ,Sociedad de Oncología y Hematología del CesarValleduparColombia
| | - Abraham Hernández
- Centro hospitalario Serena del Mar, Cartagena, Colombia, Centro hospitalario Serena del MarCartagenaColombia
| | - Juliana Rodríguez
- Fundación Santafé de Bogotá, Bogotá, Colombia. Departamento de obstetricia y ginecología Universidad Nacional de Colombia, Bogotá, Colombia. Instituto Nacional de Cancerología, Bogotá, Colombia, ,Universidad Nacional de ColombiaUniversidad Nacional de ColombiaBogotáColombia
| | - Angélica V. Fletcher
- Centro de Investigaciones Oncológicas Clínica San Diego (CIOSAD), Bogotá, Colombia, ,Centro de Investigaciones Oncológicas Clínica San Diego (CIOSAD)BogotáColombia
| | - Heydi M. Ramírez
- Fundación Valle de Lili, Cali, Colombia, ,Fundación Valle de LiliCaliColombia
| | - Oscar M. Niño
- Hospital San Ignacio, Bogotá, Colombia, ,Hospital San IgnacioBogotáColombia
| | - Diego A. Gómez
- . Hospital Internacional de Colombia, Bucaramanga, Colombia, ,Hospital Internacional de ColombiaBucaramangaColombia
| | - Daniel Sanabria
- Fundación Santafé de Bogotá, Bogotá, Colombia, ,Fundación Santafé de BogotáBogotáColombia
| | - Fernando Contreras
- Instituto Nacional de Cancerología, Bogotá, Colombia, ,Instituto Nacional de CancerologíaBogotáColombia
| | | | - Pedro H. Calderón
- Instituto Nacional de Cancerología, Bogotá, Colombia, Instituto Nacional de CancerologíaBogotáColombia
| |
Collapse
|
47
|
Da-Anoy A, Kang EY, Lee CH, Cheasley D, Llaurado Fernandez M, Carey MS, Cameron A, Köbel M. Molecular Surrogate Subtypes of Ovarian and Peritoneal Low-grade Serous Carcinoma. Int J Gynecol Pathol 2024:00004347-990000000-00168. [PMID: 38914014 DOI: 10.1097/pgp.0000000000001043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Low-grade serous carcinoma (LGSC) is an uncommon histotype of ovarian carcinoma, accounting for ~3% of cases. There is evidence that survival of peritoneal LGSC (pLGSC) is longer than that of ovarian LGSC (oLGSC). Key molecular alterations of LGSC have been established, including loss of CDKN2A and PR expression, MAPK pathway alterations, and loss of USP9X expression. We hypothesized that LGSC could be subclassified into clinically applicable molecular subtypes by a few surrogate tests similar to endometrioid carcinomas using a hierarchical decision tree based on the strength of the prognostic associations of the individual alterations. Our study included 71 LGSCs. Immunohistochemistry for CDKN2A, ER, PR, NF1, and USP9X and sequencing for KRAS, NRAS, and BRAF were performed. Our data showed the co-occurrence of key molecular alterations, and despite suggestive trends, hierarchical molecular subtyping did not provide significantly different stratification of patients according to survival in this cohort. We confirmed that patients diagnosed with pLGSC have a longer survival than high-stage oLGSC, with the intriguing observation that normal CDKN2A and PR status were associated with excellent survival in pLGSC. Therefore, CDKN2A and PR status might aid in the classification of indeterminate implants, where abnormal findings favor pLGSC over noninvasive implants. Molecular subtypes should be further evaluated in larger cohorts for their prognostic and potentially predictive value.
Collapse
Affiliation(s)
- Annalyn Da-Anoy
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary
| | - Eun Young Kang
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary
| | - Cheng Han Lee
- Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta
| | - Dane Cheasley
- Cancer Genetics Laboratory, Peter MacCallum Cancer Centre, Melbourne
- Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia
| | - Marta Llaurado Fernandez
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of British Columbia, and the Department of Clinical Research, BC Cancer, Vancouver, BC
| | - Mark S Carey
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of British Columbia, and the Department of Clinical Research, BC Cancer, Vancouver, BC
| | - Anna Cameron
- Department of Obstetrics & Gynecology, Faculty of Medicine, University of British Columbia, and the Department of Clinical Research, BC Cancer, Vancouver, BC
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary
| |
Collapse
|
48
|
Rodman EPB, Emch MJ, Hou X, Bajaj A, Pearson NA, John AJ, Ortiz Y, Bass AD, Singh S, Baldassarre G, Kaufmann SH, Weroha SJ, Hawse JR. Lestaurtinib's antineoplastic activity converges on JAK/STAT signaling to inhibit advanced forms of therapy resistant ovarian cancer. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.06.597753. [PMID: 38895264 PMCID: PMC11185641 DOI: 10.1101/2024.06.06.597753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Ovarian cancer is the deadliest gynecological malignancy, owing to its late-stage diagnosis and high rates of recurrence and resistance following standard-of-care treatment, highlighting the need for novel treatment approaches. Through an unbiased drug screen, we identified the kinase inhibitor, lestaurtinib, as a potent antineoplastic agent for chemotherapy- and PARP-inhibitor (PARPi)-sensitive and -resistant ovarian cancer cells and patient derived xenografts (PDXs). RNA-sequencing revealed that lestaurtinib potently suppressed JAK/STAT signaling and lestaurtinib efficacy was shown to be directly related to JAK/STAT pathway activity in cell lines and PDX models. Most ovarian cancer cells exhibited constitutive JAK/STAT pathway activation and genetic loss of STAT1 and STAT3 resulted in growth inhibition. Lestaurtinib also displayed synergy when combined with cisplatin and olaparib, including in a model of PARPi resistance. In contrast, the most well-known JAK/STAT inhibitor, ruxolitinib, lacked antineoplastic activity against all ovarian cancer cell lines and PDX models tested. This divergent behavior was reflected in the ability of lestaurtinib to block both Y701/705 and S727 phosphorylation of STAT1 and STAT3, whereas ruxolitinib failed to block S727. Consistent with these findings, lestaurtinib additionally inhibited JNK and ERK activity, leading to more complete suppression of STAT phosphorylation. Concordantly, combinatorial treatment with ruxolitinib and a JNK or ERK inhibitor resulted in synergistic antineoplastic effects at dose levels where single agents were ineffective. Taken together, these findings indicate that lestaurtinib, and other treatments that converge on JAK/STAT signaling, are worthy of further pre-clinical and clinical exploration for the treatment of highly aggressive and advanced forms of ovarian cancer. Statement of significance Lestaurtinib is a novel inhibitor of ovarian cancer, including chemotherapy- and PARPi-resistant models, that acts through robust inhibition of the JAK/STAT pathway and synergizes with standard-of-care agents at clinically relevant concentrations.
Collapse
|
49
|
Stiegeler N, Garsed DW, Au-Yeung G, Bowtell DDL, Heinzelmann-Schwarz V, Zwimpfer TA. Homologous recombination proficient subtypes of high-grade serous ovarian cancer: treatment options for a poor prognosis group. Front Oncol 2024; 14:1387281. [PMID: 38894867 PMCID: PMC11183307 DOI: 10.3389/fonc.2024.1387281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Approximately 50% of tubo-ovarian high-grade serous carcinomas (HGSCs) have functional homologous recombination-mediated (HR) DNA repair, so-called HR-proficient tumors, which are often associated with primary platinum resistance (relapse within six months after completion of first-line therapy), minimal benefit from poly(ADP-ribose) polymerase (PARP) inhibitors, and shorter survival. HR-proficient tumors comprise multiple molecular subtypes including cases with CCNE1 amplification, AKT2 amplification or CDK12 alteration, and are often characterized as "cold" tumors with fewer infiltrating lymphocytes and decreased expression of PD-1/PD-L1. Several new treatment approaches aim to manipulate these negative prognostic features and render HR-proficient tumors more susceptible to treatment. Alterations in multiple different molecules and pathways in the DNA damage response are driving new drug development to target HR-proficient cancer cells, such as inhibitors of the CDK or P13K/AKT pathways, as well as ATR inhibitors. Treatment combinations with chemotherapy or PARP inhibitors and agents targeting DNA replication stress have shown promising preclinical and clinical results. New approaches in immunotherapy are also being explored, including vaccines or antibody drug conjugates. Many approaches are still in the early stages of development and further clinical trials will determine their clinical relevance. There is a need to include HR-proficient tumors in ovarian cancer trials and to analyze them in a more targeted manner to provide further evidence for their specific therapy, as this will be crucial in improving the overall prognosis of HGSC and ovarian cancer in general.
Collapse
Affiliation(s)
| | - Dale W. Garsed
- Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - George Au-Yeung
- Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - David D. L. Bowtell
- Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Tibor A. Zwimpfer
- Cancer Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Gynecological Oncology, University Hospital Basel, Basel, Switzerland
| |
Collapse
|
50
|
Xu D, Wang W, Wang D, Ding J, Zhou Y, Zhang W. Long noncoding RNA MALAT-1: A versatile regulator in cancer progression, metastasis, immunity, and therapeutic resistance. Noncoding RNA Res 2024; 9:388-406. [PMID: 38511067 PMCID: PMC10950606 DOI: 10.1016/j.ncrna.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/22/2024] Open
Abstract
Long noncoding RNAs (lncRNAs) are RNA transcripts longer than 200 nucleotides that do not code for proteins but have been linked to cancer development and metastasis. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) influences crucial cancer hallmarks through intricate molecular mechanisms, including proliferation, invasion, angiogenesis, apoptosis, and the epithelial-mesenchymal transition (EMT). The current article highlights the involvement of MALAT-1 in drug resistance, making it a potential target to overcome chemotherapy refractoriness. It discusses the impact of MALAT-1 on immunomodulatory molecules, such as major histocompatibility complex (MHC) proteins and PD-L1, leading to immune evasion and hindering anti-tumor immune responses. MALAT-1 also plays a significant role in cancer immunology by regulating diverse immune cell populations. In summary, MALAT-1 is a versatile cancer regulator, influencing tumorigenesis, chemoresistance, and immunotherapy responses. Understanding its precise molecular mechanisms is crucial for developing targeted therapies, and therapeutic strategies targeting MALAT-1 show promise for improving cancer treatment outcomes. However, further research is needed to fully uncover the role of MALAT-1 in cancer biology and translate these findings into clinical applications.
Collapse
Affiliation(s)
- Dexin Xu
- Department of Orthopedics, Jilin Province FAW General Hospital, Changchun, 130000, China
| | - Wenhai Wang
- Department of Cardiology, Jilin Province FAW General Hospital, Changchun, 130000, China
| | - Duo Wang
- Department of Geriatrics, Jilin Province FAW General Hospital, Changchun, 130000, China
| | - Jian Ding
- Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, 130000, China
| | - Yunan Zhou
- Department of Orthopedics, Jilin Province FAW General Hospital, Changchun, 130000, China
| | - Wenbin Zhang
- Department of Cardiology, Jilin Province FAW General Hospital, Changchun, 130000, China
| |
Collapse
|