1
|
Bentestuen M, Ladekarl M, Knudsen A, Zacho HD. Diagnostic accuracy and clinical value of [68Ga]Ga-FAPI-46 PET/CT for staging patients with ovarian cancer: study protocol for a prospective clinical trial. BMC Cancer 2024; 24:699. [PMID: 38849741 PMCID: PMC11157941 DOI: 10.1186/s12885-024-12461-w] [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: 01/29/2024] [Accepted: 05/31/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND [18F]Fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) is recommended during diagnostic work-up for ovarian cancer; however, [18F]FDG PET has several inherent limitations. The novel oncologic PET-tracer fibroblast activation protein inhibitor (FAPI) has demonstrated promising results in multiple cancer types, including ovarian cancer, and could overcome the limitations of [18F]FDG PET; however, high-quality clinical studies are lacking. The primary objective of the present study is to compare the diagnostic accuracy of [68Ga]Ga-FAPI-46 PET/CT and [18F]FDG PET/CT in ovarian cancer patients and to investigate how this potential difference impacts staging and patient management. METHODS AND DESIGN Fifty consecutive ovarian cancer patients will be recruited from Aalborg University Hospital, Denmark. This study will be a single-center, prospective, exploratory clinical trial that adheres to the standards for reporting diagnostic accuracy studies (STARD). This study will be conducted under continuous Good Clinical Practice monitoring. The eligibility criteria for patients are as follows: (1) biopsy verified newly diagnosed ovarian cancer or a high risk of ovarian cancer and referred for primary staging with [18F]FDG PET/CT; and (2) resectable disease, i.e., candidate for primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery. All recruited study subjects will undergo [68Ga]Ga-FAPI-46 PET/CT at primary staging, before primary debulking surgery or neoadjuvant chemotherapy (Group A + B), in addition to conventional imaging (including [18F]FDG PET/CT). Study subjects in Group B will undergo an additional [68Ga]Ga-FAPI-46 PET/CT following neoadjuvant chemotherapy prior to interval debulking surgery. The results of the study-related [68Ga]Ga-FAPI-46 PET/CTs will be blinded, and treatment allocation will be based on common clinical practice in accordance with current guidelines. The histopathology of surgical specimens will serve as a reference standard. A recruitment period of 2 years is estimated; the trial is currently recruiting. DISCUSSION To our knowledge, this trial represents the largest, most extensive, and most meticulous prospective FAPI PET study conducted in patients with ovarian cancer thus far. This study aims to obtain a reliable estimation of the diagnostic accuracy of [68Ga]Ga-FAPI-46 PET/CT, shed light on the clinical importance of [68Ga]Ga-FAPI-46 PET/CT, and examine the potential applicability of [68Ga]Ga-FAPI-46 PET/CT for evaluating chemotherapy response. TRIAL REGISTRATION clinicaltrials.gov: NCT05903807, 2nd June 2023; and euclinicaltrials.eu EU CT Number: 2023-505938-98-00, authorized 11th September 2023.
Collapse
Affiliation(s)
- Morten Bentestuen
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18- 22, Aalborg, DK-9000, Denmark.
- Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 11, Aalborg, DK-9000, Denmark.
| | - Morten Ladekarl
- Department of Oncology and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18-22, Aalborg, DK- 9000, Denmark
- Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 11, Aalborg, DK-9000, Denmark
| | - Aage Knudsen
- Department of Gynecology and Obstetrics, Aalborg University Hospital, Reberbansgade 15, Aalborg, DK-9000, Denmark
- Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 11, Aalborg, DK-9000, Denmark
| | - Helle D Zacho
- Department of Nuclear Medicine and Clinical Cancer Research Center, Aalborg University Hospital, Hobrovej 18- 22, Aalborg, DK-9000, Denmark
- Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 11, Aalborg, DK-9000, Denmark
| |
Collapse
|
2
|
Han GH, Kim HR, Yun H, Kim JH, Cho H. Comparison of Adverse Events Between PARP Inhibitors in Patients with Epithelial Ovarian Cancer: A Nationwide Propensity Score Matched Cohort Study. Target Oncol 2024; 19:251-262. [PMID: 38416378 DOI: 10.1007/s11523-024-01037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Despite improvement in progression-free survival (PFS) with poly (ADP-ribose) polymerase (PARP) inhibitors (PARPi) as maintenance treatment for patients with epithelial ovarian cancer (EOC), a comparative analysis of clinical events of interest (CEIs) of different PARPi is scarce. OBJECTIVE This study aimed to compare the safety of different PARPi in patients with EOC. PATIENTS AND METHODS Through analyzing the Korean National Health Insurance Service from January 2009 to January 2022, this study involved BRCA-mutated, platinum-sensitive patients with EOC treated with olaparib (tablet), niraparib, and olaparib (capsule) as first-line or second-line maintenance treatment. CEIs were identified using International Statistical Classification of Diseases (ICD) 9/10 codes, with additional outcomes being dose modification and persistence. RESULTS In the first-line maintenance treatment [118 niraparib, 104 olaparib (tablet) patients], no significant differences were noted in CEIs, dose reduction, or 6-month discontinuation rate. For second-line maintenance treatment [303 niraparib, 126 olaparib (tablet), and 675 olaparib (capsule) patients], niraparib was associated with a higher risk of hematologic CEIs, particularly anemia, compared with olaparib (tablet) (0.51 [0.26-0.98] and 0.09 [0.01-0.74], respectively), and higher rate of discontinuation rate at 6 months. Of note, patients over 60 years old showed an increased risk of CEIs with niraparib, as indicated by the hazard ratio divergence in restricted cubic spline plots. CONCLUSIONS No differences were observed among the PARPi during first-line maintenance treatment. However, in the second-line maintenance treatment, significant differences were observed in the risk of experiencing CEIs, dose alteration possibilities, and discontinuation of PARPi between niraparib and olaparib (tablets). Moreover, our findings suggest that an age of 60 years may be a critical factor in selecting PARPi to reduce CEI incidence.
Collapse
Affiliation(s)
- Gwan Hee Han
- Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 01757, Republic of Korea
| | - Hae-Rim Kim
- Department of Statistics, College of Natural Science, University of Seoul, Seoul, 02504, Republic of Korea
| | - Hee Yun
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 06299, Republic of Korea
| | - Jae-Hoon Kim
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, 03772, Republic of Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hanbyoul Cho
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, 03772, Republic of Korea.
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
| |
Collapse
|
3
|
Wang P, Feng Y, Qi H, Feng H, Chen Y, Zeng G, Dai W. Diagnostic value of serum CA125 combined with PET/CT in ovarian cancer and tuberculous peritonitis in female patients. Abdom Radiol (NY) 2023; 48:3449-3457. [PMID: 37493838 DOI: 10.1007/s00261-023-03997-9] [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: 02/07/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE To evaluate the diagnostic value of serum CA125 combined with 18F-FDG PET/CT in ovarian cancer (OC) and tuberculous peritonitis (TBP) in female patients and to establish a diagnostic scoring system. METHOD A total of 86 female patients (64 OC and 22 TBP) were included in this study. Serum CA125, PET/CT maximal intensity projection (MIP), maximal standardized uptake value, ovarian mass, ascites volume, and other indicators were analyzed and a diagnostic scoring system was established according to the weights of statistically significant indicators. RESULTS Univariate analysis showed that serum CA125 in OC and TBP patients were 2079.9 ± 1651.3 U/mL and 448.3 ± 349.5 U/mL (P < 0.001). In MIP images, abdominal lesions were focal distribution in 92.2% (59/64) of OC patients and diffuse distribution in 95.5% (21/22) of TBP patients (P < 0.001). Ovarian masses could be observed in 82.8% (53/64) OC patients and 31.8% (7/22) TBP patients (P <0.001). The other indicators were not statistically significant. Logistic regression analysis showed that serum CA125 and MIP were independent risk factors for diagnosis. A diagnostic scoring system could be established based on serum CA125, MIP and ovarian mass, and the diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 98.4% (63/64), 95.5% (21/22), 97.7% (84/86), 98.4% (63/64), and 95.5% (21/22), respectively. CONCLUSION Serum CA125 combined with PET/CT is of great value in the diagnosis of OC and TBP. A simple and efficient diagnostic scoring system can be established using serum CA125, MIP image feature, and ovarian mass.
Collapse
Affiliation(s)
- Peng Wang
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Yawen Feng
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Hongyan Qi
- Department of Ultrasound, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
| | - Hui Feng
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Yuqi Chen
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China
| | - Guoliang Zeng
- Zhijiang People's Hospital, Yichang, Hubei, PR China.
| | - Wenli Dai
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, PR China.
- Yichang Key Laboratory of Nuclear Medicine and Molecular Imaging, Yichang, Hubei, PR China.
| |
Collapse
|
4
|
Chen J, Hu J, Gu L, Ji F, Zhang F, Zhang M, Li J, Chen Z, Jiang L, Zhang Y, Shi R, Ma L, Jia S, Zhang Y, Zhang Q, Liang J, Yao S, Hu Z, Guo Z. Anti-mesothelin CAR-T immunotherapy in patients with ovarian cancer. Cancer Immunol Immunother 2023; 72:409-425. [PMID: 35925286 DOI: 10.1007/s00262-022-03238-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/06/2022] [Indexed: 01/29/2023]
Abstract
Recently, chimeric antigen receptor T cell (CAR-T) therapy has received increasing attention as an adoptive cellular immunotherapy that targets tumors. However, numerous challenges remain for the effective use of CAR-T to treat solid tumors, including ovarian cancer, which is an aggressive and metastatic cancer with a poor therapeutic response. We screened for an effective anti-MSLN single-chain Fv antibody with comparable binding activity and non-off-target properties using human phage display library. A second-generation of anti-MSLN CAR was designed and generated. We demonstrated the efficacy of our anti-MSLN CAR-T cells for ovarian cancer treatment in an in vitro experiment to kill ovarian tumor cell lines. The anti-MSLN CAR-T cells impeded MSLN-positive tumor growth concomitant with a significant increase in cytokine levels compared with the control. Then, we demonstrated the efficacy of anti-MSLN CAR-T cells in an in vivo experiment against ovarian cancer cell-derived xenografts. Furthermore, we herein report three cases with ovarian cancer who were treated with autologous anti-MSLN CAR-T cells and evaluate the safety and effectiveness of adoptive cell therapy. In this investigator-initiated clinical trials, no patients experienced cytokine release syndrome or neurological symptoms over 2 grads. Disease stabilized in two patients, with progression-free survival times of 5.8 and 4.6 months. Transient CAR expression was detected in patient blood after infusion each time. The tumor partially subsided, and the patient's condition was relieved. In conclusion, this work proves the efficacy of the anti-MSLN CAR-T treatment strategy in ovarian cancer and provides preliminary data for the development of further clinical trials.
Collapse
Affiliation(s)
- Jiannan Chen
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China
| | - Jianhua Hu
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Lili Gu
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China
| | - Feng Ji
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China
| | - Fan Zhang
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China
| | - Miaomiao Zhang
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China
| | - Jun Li
- Nanjing Blue Shield Biotechnology Co., Ltd., Nanjing, 210023, China
| | - Zhengliang Chen
- Nanjing Blue Shield Biotechnology Co., Ltd., Nanjing, 210023, China
| | - Longwei Jiang
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Yan Zhang
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Ruifang Shi
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Lihua Ma
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Shaochang Jia
- Department of Biotherapy, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Ying Zhang
- Department of Pathology, Jinling Hospital of Nanjing University School of Medicine, Nanjing, 210002, China
| | - Qi Zhang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, 210009, China
| | - Junqing Liang
- Inner Mongolia Autonomous Region Cancer Hospital, Hohhot, 010010, China
| | - Shunyu Yao
- Baylor University, 1311 S 5th St, Waco, USA
| | - Zhigang Hu
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China.
| | - Zhigang Guo
- Jiangsu Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing, 210023, China.
| |
Collapse
|
5
|
Kujala A, Valkonen E, Sallinen H, Tuppurainen L, Laakso H, Ylä-Herttuala E, Liimatainen T, Kujala J, Jokelainen O, Sironen R, Anttila M, Ylä-Herttuala S. AAV8-mediated sVEGFR2 and sVEGFR3 gene therapy combined with chemotherapy reduces the growth and microvasculature of human ovarian cancer and prolongs the survival in mice. Front Med (Lausanne) 2022; 9:1018208. [PMID: 36569136 PMCID: PMC9773272 DOI: 10.3389/fmed.2022.1018208] [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: 08/12/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Background Vascular endothelial growth factors (VEGFs) are major regulators of intratumoral angiogenesis in ovarian cancer (OVCA). Overexpression of VEGFs is associated with increased tumor growth and metastatic tendency and VEGF-targeting therapies are thus considered as potential treatments for OVCA. Here, we examined the antiangiogenic and antitumoral effects on OVCA of adeno-associated virus 8 (AAV8)-mediated expression of soluble VEGF receptors (sVEGFRs) sVEGFR2 and sVEGFR3 together with paclitaxel and carboplatin chemotherapy. Materials and methods Immunodeficient mice were inoculated with human OVCA cell line SKOV-3m. Development of tumors was confirmed with magnetic resonance imaging (MRI) and mice were treated with gene therapy and paclitaxel and carboplatin chemotherapy. The study groups included (I) non-treated control group, (II) blank control vector AAV8-CMV, (III) AAV8-CMV with chemotherapy, (IV) AAV8-sVEGFR2, (V) AAV8-sVEGFR3, (VI) AAV8-sVEGFR2 and AAV8-sVEGFR3, and (VII) AAV8-sVEGFR2 and AAV8-sVEGFR3 with chemotherapy. Antiangiogenic and antitumoral effects were evaluated with immunohistochemical stainings and serial MRI. Results Reduced intratumoral angiogenesis was observed in all antiangiogenic gene therapy groups. The combined use of AAV8-sVEGFR2 and AAV8-sVEGFR3 with chemotherapy suppressed ascites fluid formation and tumor growth, thus improving the overall survival of mice. Antitumoral effect was mainly caused by AAV8-sVEGFR2 while the benefits of AAV8-sVEGFR3 and chemotherapy were less prominent. Conclusion Combined use of the AAV8-sVEGFR2 and AAV8-sVEGFR3 with chemotherapy reduces intratumoral angiogenesis and tumor growth in OVCA mouse model. Results provide preclinical proof-of-concept for the use of soluble decoy VEGFRs and especially the AAV8-sVEGFR2 in the treatment of OVCA.
Collapse
Affiliation(s)
- Anni Kujala
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Elina Valkonen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanna Sallinen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland,Department of Gynecology, Kuopio University Hospital, Kuopio, Finland,School of Medicine, Gynecology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Laura Tuppurainen
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanne Laakso
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Elias Ylä-Herttuala
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland,Clinical Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Timo Liimatainen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Jouni Kujala
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
| | - Otto Jokelainen
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland,Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - Reijo Sironen
- Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland,Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - Maarit Anttila
- Department of Gynecology, Kuopio University Hospital, Kuopio, Finland,School of Medicine, Gynecology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- Department of Biotechnology and Molecular Medicine, A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland,Heart Center and Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland,*Correspondence: Seppo Ylä-Herttuala,
| |
Collapse
|
6
|
Fidahussain AA, Abid A, Paracha AA, Jeevan VE, Rueve J, Engelhardt M, Schrock C, Ghani S, Nair HK. An Etiological Investigation of Paraneoplastic Cerebellar Degeneration in Ovarian Cancer Patients: A Systematic Review. Cureus 2022; 14:e31154. [DOI: 10.7759/cureus.31154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 11/07/2022] Open
|
7
|
Oda K, Aoki D, Tsuda H, Nishihara H, Aoyama H, Inomata H, Shimada M, Enomoto T. Japanese nationwide observational multicenter study of tumor BRCA1/2 variant testing in advanced ovarian cancer. Cancer Sci 2022; 114:271-280. [PMID: 36254756 PMCID: PMC9807512 DOI: 10.1111/cas.15518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/13/2022] [Accepted: 07/26/2022] [Indexed: 01/07/2023] Open
Abstract
The association between germline BRCA1 and BRCA2 pathogenic variants (mutations: gBRCAm) and ovarian cancer risk is well established. Germline testing alone cannot detect somatic BRCA1/2 pathogenic variants (sBRCAm), which is calculated based on the proportion of tumor BRCAm (tBRCAm) from tumor samples and gBRCAm. Homologous recombination deficiency (HRD) results mainly from genetic/epigenetic alterations in homologous recombination repair-related genes and can be evaluated by genomic instability status. In Japan, the prevalence of tBRCAm, sBRCAm, and HRD remains unclear. This multicenter, cross-sectional, observational study, CHaRacterIzing the croSs-secTional approach to invEstigate the prevaLence of tissue BRCA1/2 mutations in newLy diagnosEd advanced ovarian cancer patients (CHRISTELLE), evaluated the prevalence of tBRCAm, sBRCAm, and HRD in tumor specimens from newly diagnosed patients with ovarian cancer who underwent gBRCA testing. Of the 205 patients analyzed, 26.8% had a tBRCAm, including tBRCA1m (17.6%) and tBRCA2m (9.3%). The overall prevalence of tBRCAm, gBRCAm, sBRCAm, and HRD-positive status was 26.8%, 21.5%, 6.3%, and 60.0%, respectively. The calculated sBRCAm/tBRCAm ratio was 23.6% (13/55), and the prevalence of gBRCA variant of uncertain significance was 3.9%. These results suggest gBRCA testing alone cannot clearly identify the best course of treatment, highlighting the importance of sBRCA testing in Japan. The present results also suggest that testing for tBRCA and HRD should be encouraged in advanced ovarian cancer patients to drive precision medicine.
Collapse
Affiliation(s)
- Katsutoshi Oda
- Division of Integrative Genomics, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Daisuke Aoki
- Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
| | - Hitoshi Tsuda
- Department of Basic PathologyNational Defense Medical CollegeSaitamaJapan
| | | | | | | | - Muneaki Shimada
- Department of Obstetrics and GynecologyTohoku University Graduate School of MedicineMiyagiJapan
| | - Takayuki Enomoto
- Department of Obstetrics and GynecologyNiigata University Medical SchoolNiigataJapan
| |
Collapse
|
8
|
A Novel Antibody-Drug Conjugate Targeting Nectin-2 Suppresses Ovarian Cancer Progression in Mouse Xenograft Models. Int J Mol Sci 2022; 23:ijms232012358. [PMID: 36293219 PMCID: PMC9604294 DOI: 10.3390/ijms232012358] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 12/04/2022] Open
Abstract
Ovarian cancer is the fifth leading cause of cancer, followed by front line is mostly platinum agents and PARP inhibitors, and very limited option in later lines. Therefore, there is a need for alternative therapeutic options. Nectin-2, which is overexpressed in ovarian cancer, is a known immune checkpoint that deregulates immune cell function. In this study, we generated a novel anti-nectin-2 antibody (chimeric 12G1, c12G1), and further characterized it using epitope mapping, enzyme-linked immunosorbent assay, surface plasmon resonance, fluorescence-activated cell sorting, and internalization assays. The c12G1 antibody specifically bound to the C2 domain of human nectin-2 with high affinity (KD = 2.90 × 10-10 M), but not to mouse nectin-2. We then generated an antibody-drug conjugate comprising the c12G1 antibody conjugated to DM1 and investigated its cytotoxic effects against cancer cells in vitro and in vivo. c12G1-DM1 induced cell cycle arrest at the mitotic phase in nectin-2-positive ovarian cancer cells, but not in nectin-2-negative cancer cells. c12G1-DM1 induced ~100-fold cytotoxicity in ovarian cancer cells, with an IC50 in the range of 0.1 nM~7.4 nM, compared to normal IgG-DM1. In addition, c12G1-DM1 showed ~91% tumor growth inhibition in mouse xenograft models transplanted with OV-90 cells. These results suggest that c12G1-DM1 could be used as a potential therapeutic agent against nectin-2-positive ovarian cancers.
Collapse
|
9
|
Akinyemiju TF, Wilson LE, Diaz N, Gupta A, Huang B, Pisu M, Deveaux A, Liang M, Previs RA, Moss HA, Joshi A, Ward KC, Schymura MJ, Berchuck A, Potosky AL. Associations of Healthcare Affordability, Availability, and Accessibility with Quality Treatment Metrics in Patients with Ovarian Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1383-1393. [PMID: 35477150 PMCID: PMC9250633 DOI: 10.1158/1055-9965.epi-21-1227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/02/2022] [Accepted: 04/18/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Differential access to quality care is associated with racial disparities in ovarian cancer survival. Few studies have examined the association of multiple healthcare access (HCA) dimensions with racial disparities in quality treatment metrics, that is, primary debulking surgery performed by a gynecologic oncologist and initiation of guideline-recommended systemic therapy. METHODS We analyzed data for patients with ovarian cancer diagnosed from 2008 to 2015 in the Surveillance, Epidemiology, and End Results-Medicare database. We defined HCA dimensions as affordability, availability, and accessibility. Modified Poisson regressions with sandwich error estimation were used to estimate the relative risk (RR) for quality treatment. RESULTS The study cohort was 7% NH-Black, 6% Hispanic, and 87% NH-White. Overall, 29% of patients received surgery and 68% initiated systemic therapy. After adjusting for clinical variables, NH-Black patients were less likely to receive surgery [RR, 0.83; 95% confidence interval (CI), 0.70-0.98]; the observed association was attenuated after adjusting for healthcare affordability, accessibility, and availability (RR, 0.91; 95% CI, 0.77-1.08). Dual enrollment in Medicaid and Medicare compared with Medicare only was associated with lower likelihood of receiving surgery (RR, 0.86; 95% CI, 0.76-0.97) and systemic therapy (RR, 0.94; 95% CI, 0.92-0.97). Receiving treatment at a facility in the highest quartile of ovarian cancer surgical volume was associated with higher likelihood of surgery (RR, 1.12; 95% CI, 1.04-1.21). CONCLUSIONS Racial differences were observed in ovarian cancer treatment quality and were partly explained by multiple HCA dimensions. IMPACT Strategies to mitigate racial disparities in ovarian cancer treatment quality must focus on multiple HCA dimensions. Additional dimensions, acceptability and accommodation, may also be key to addressing disparities.
Collapse
Affiliation(s)
- Tomi F. Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
- Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Lauren E. Wilson
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Nicole Diaz
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Anjali Gupta
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Bin Huang
- Department of Biostatistics and Kentucky Cancer Registry, Univ of Kentucky, Lexington KY
| | - Maria Pisu
- Division of Preventive Medicine and O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - April Deveaux
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Margaret Liang
- Division of Preventive Medicine and O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL
| | - Rebecca A. Previs
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Haley A. Moss
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Ashwini Joshi
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Kevin C. Ward
- Georgia Cancer Registry, Emory University, Atlanta GA
| | - Maria J. Schymura
- New York State Cancer Registry, New York State Department of Health, Albany NY
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Duke Cancer Institute, Duke University School of Medicine, Durham NC
| | - Arnold L. Potosky
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC
| |
Collapse
|
10
|
Luo J, Ou S, Wei H, Qin X, Jiang Q. Comparative Efficacy and Safety of Poly (ADP-Ribose) Polymerase Inhibitors in Patients With Ovarian Cancer: A Systematic Review and Network Meta-Analysis. Front Oncol 2022; 12:815265. [PMID: 35756600 PMCID: PMC9213680 DOI: 10.3389/fonc.2022.815265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This study aims to compare the efficacy and safety of different poly (ADP-ribose) polymerase (PARP) inhibitors in patients with ovarian cancer through a network meta-analysis to support clinical treatment choices. Methods The Cochrane Library, PubMed, Embase, Science Citation Index, China National Knowledge Infrastructure (CNKI), Wanfang Data, Chongqing VIP (CQVIP), and Chinese BioMedical Literature Database (CBM) were searched with a cutoff date of 14 January 2021. ClinicalTrials.gov was also checked for supplementary data. Phase II or III randomized controlled trials that compared a PARP inhibitor with a placebo in patients with relapsed or newly diagnosed advanced ovarian cancer were included. The hazard ratios (HRs) for progression-free survival and overall survival and odds ratios (ORs) for grade 3 or higher adverse events were analyzed. The network meta-analysis was conducted in a Bayesian framework based on the Markov Chain Monte Carlo model in the R gemtc package (version 4.0.3). Results Eight eligible articles reporting six trials with a total of 2,801 patients were incorporated in this network meta-analysis. Three trials compared olaparib with placebo. Two trials compared niraparib with placebo. One trial compared rucaparib with placebo. The network meta-analysis failed to show significant differences in progression-free survival among the three PARP inhibitors: HR of 0.64, 95% confidence interval of 0.3 to 1.42 for olaparib versus niraparib, and olaparib versus rucaparib (0.86; 0.33 to 2.33). The comparison between niraparib and rucaparib also did not express a statistical difference (1.34; 0.47 to 3.72). Subgroup analysis bybreast cancer susceptibility gene (BRCA) status showed no obvious difference in progression-free survival among the three PARP inhibitors regardless of BRCA mutation status. Olaparib had fewer grade 3 or higher adverse events than niraparib (OR, 0.27; 95% confidence interval, 0.13 to 0.55) and rucaparib (0.34; 0.14 to 0.86). However, the analysis failed to show a significant difference between niraparib and rucaparib (1.27; 0.49 to 3.27). Conclusion Current evidence indicates that there is no significant difference observed in efficacy among olaparib, niraparib, and rucaparib. However, olaparib might have fewer grade 3 or higher adverse events.
Collapse
Affiliation(s)
- Jing Luo
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shunlong Ou
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Hua Wei
- Department of Pharmacy, Dujiangyan People's Hospital, Dujiangyan Medical Center, Dujiangyan, China
| | - Xiaoli Qin
- School of Pharmacy, Chengdu Medical College, Chengdu, China
| | - Qian Jiang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Centre, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
11
|
Hermens M, van Altena AM, Bulten J, van Vliet HAAM, Siebers AG, Bekkers RLM. Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis. Fertil Steril 2022; 117:938-945. [PMID: 35300832 DOI: 10.1016/j.fertnstert.2022.01.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/16/2022] [Accepted: 01/25/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO). DESIGN Retrospective nationwide cohort study. SETTING Dutch pathology database. PATIENT(S) Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535). INTERVENTION(S) Observational study. MAIN OUTCOME MEASURE(S) Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated. RESULT(S) We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591). CONCLUSION(S) In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.
Collapse
Affiliation(s)
- Marjolein Hermens
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, the Netherlands; Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Anne M van Altena
- Department of Obstetrics & Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Johan Bulten
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Huib A A M van Vliet
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, the Netherlands; Department of Obstetrics and Gynecology, University Hospital Ghent, Ghent, Belgium
| | - Albert G Siebers
- Dutch Nationwide Registry of Histopathology and Cytopathology-Pathologisch Anatomisch Landelijk Geautomatiseerd Archief (PALGA), Houten, the Netherlands
| | - Ruud L M Bekkers
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, the Netherlands; GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| |
Collapse
|
12
|
Hollis RL, Stillie LJ, Hopkins S, Bartos C, Churchman M, Rye T, Nussey F, Fegan S, Nirsimloo R, Inman GJ, Herrington CS, Gourley C. Clinicopathological Determinants of Recurrence Risk and Survival in Mucinous Ovarian Carcinoma. Cancers (Basel) 2021; 13:5839. [PMID: 34830992 PMCID: PMC8616033 DOI: 10.3390/cancers13225839] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022] Open
Abstract
Mucinous ovarian carcinoma (MOC) is a unique form of ovarian cancer. MOC typically presents at early stage but demonstrates intrinsic chemoresistance; treatment of advanced-stage and relapsed disease is therefore challenging. We harness a large retrospective MOC cohort to identify factors associated with recurrence risk and survival. A total of 151 MOC patients were included. The 5 year disease-specific survival (DSS) was 84.5%. Risk of subsequent recurrence after a disease-free period of 2 and 5 years was low (8.3% and 5.6% over the next 10 years). The majority of cases were FIGO stage I (35.6% IA, 43.0% IC). Multivariable analysis identified stage and pathological grade as independently associated with DSS (p < 0.001 and p < 0.001). Grade 1 stage I patients represented the majority of cases (53.0%) and demonstrated exceptional survival (10 year DSS 95.3%); survival was comparable between grade I stage IA and stage IC patients, and between grade I stage IC patients who did and did not receive adjuvant chemotherapy. At 5 years following diagnosis, the proportion of grade 1, 2 and 3 patients remaining disease free was 89.5%, 74.9% and 41.7%; the corresponding proportions for FIGO stage I, II and III/IV patients were 91.1%, 76.7% and 19.8%. Median post-relapse survival was 5.0 months. Most MOC patients present with low-grade early-stage disease and are at low risk of recurrence. New treatment options are urgently needed to improve survival following relapse, which is associated with extremely poor prognosis.
Collapse
Affiliation(s)
- Robert L. Hollis
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| | - Lorna J. Stillie
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
- Cancer Research UK Beatson Institute, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, Scotland, UK;
| | - Samantha Hopkins
- Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Edinburgh EH4 2LF, Scotland, UK; (S.H.); (F.N.); (R.N.)
| | - Clare Bartos
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| | - Michael Churchman
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| | - Tzyvia Rye
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| | - Fiona Nussey
- Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Edinburgh EH4 2LF, Scotland, UK; (S.H.); (F.N.); (R.N.)
| | - Scott Fegan
- The Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh EH16 4TJ, Scotland, UK;
| | - Rachel Nirsimloo
- Edinburgh Cancer Centre, Western General Hospital, NHS Lothian, Edinburgh EH4 2LF, Scotland, UK; (S.H.); (F.N.); (R.N.)
| | - Gareth J. Inman
- Cancer Research UK Beatson Institute, Institute of Cancer Sciences, University of Glasgow, Glasgow G61 1BD, Scotland, UK;
| | - C. Simon Herrington
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| | - Charlie Gourley
- The Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK; (L.J.S.); (C.B.); (M.C.); (T.R.); (C.S.H.); (C.G.)
| |
Collapse
|
13
|
Delgado Bolton RC, Aide N, Colletti PM, Ferrero A, Paez D, Skanjeti A, Giammarile F. EANM guideline on the role of 2-[ 18F]FDG PET/CT in diagnosis, staging, prognostic value, therapy assessment and restaging of ovarian cancer, endorsed by the American College of Nuclear Medicine (ACNM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the International Atomic Energy Agency (IAEA). Eur J Nucl Med Mol Imaging 2021; 48:3286-3302. [PMID: 34215923 DOI: 10.1007/s00259-021-05450-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 10/20/2022]
Abstract
In most patients with ovarian carcinoma, the diagnosis is reached when the disease is long past the initial stages, presenting already an advanced stage, and they usually have a very bad prognosis. Cytoreductive or debulking surgical procedures, platinum-based chemotherapy and targeted agents are key therapeutic elements. However, around 7 out of 10 patients present recurrent disease within 36 months from the initial diagnosis. The metastatic spread in ovarian cancer follows three pathways: contiguous dissemination across the peritoneum, dissemination through the lymphatic drainage and, although less importantly in this case, through the bloodstream. Radiological imaging, including ultrasound, CT and MRI, are the main imaging techniques in which management decisions are supported, CT being considered the best available technique for presurgical evaluation and staging purposes. Regarding 2-[18F]FDG PET/CT, the evidence available in the literature demonstrates efficacy in primary detection, disease staging and establishing the prognosis and especially for relapse detection. There is limited evidence when considering the evaluation of therapeutic response. This guideline summarizes the level of evidence and grade of recommendation for the clinical indications of 2-[18F]FDG PET/CT in each disease stage of ovarian carcinoma.
Collapse
Affiliation(s)
- Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja (CIBIR), La Rioja, Logroño, Spain.
| | - Nicolas Aide
- Department of Nuclear Medicine, Caen University Hospital, Caen, France.,INSERM U1086 ANTICIPE, Normandie Université, Caen, France
| | - Patrick M Colletti
- Department of Radiology, University of Southern California, Los Angeles, CA, USA
| | - Annamaria Ferrero
- Academic Division Gynaecology and Obstetrics, University of Torino, Mauriziano Hospital, Torino, Italy
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency (IAEA), Vienna, Austria
| | - Andrea Skanjeti
- Department of Nuclear Medicine, Hospices Civils de Lyon, Université Claude Bernard, Lyon 1, Lyon, France
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, International Atomic Energy Agency (IAEA), Vienna, Austria.,Department of Nuclear Medicine, Centre Léon Bérard, Lyon, France
| |
Collapse
|
14
|
Shin DW, Bae J, Ha J, Jung KW. Conditional Relative Survival of Ovarian Cancer: A Korean National Cancer Registry Study. Front Oncol 2021; 11:639839. [PMID: 33996553 PMCID: PMC8113866 DOI: 10.3389/fonc.2021.639839] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/30/2021] [Indexed: 12/24/2022] Open
Abstract
Objective Conditional relative survival (CRS) rates, which take into account changes in prognosis over time, are useful estimates for survivors and their clinicians as they make medical and personal decisions. We aimed to present the 5-year relative conditional survival probabilities of patients diagnosed with ovarian cancer from 1997–2016. Methods This nationwide retrospective cohort study used data from the Korean Central Cancer Registry. Patients diagnosed with ovarian cancer between 1997 and 2016 were included. CRS rates were calculated stratified by age at diagnosis, cancer stage, histology, treatment received, year of diagnosis, and social deprivation index. Results The 5-year relative survival rate at the time of diagnosis was 61.1% for all cases. The probability of surviving an additional 5 years, conditioned on having already survived 1, 2, 3, 4, and 5 years after diagnosis was 65.0, 69.5, 74.6, 79.3, and 83.9%, respectively. Patients with poorer initial survival estimates (older, distant stage, serous histology) generally showed the largest increases in CRS over time. The probability of death was highest in the first year after diagnosis (11.8%), and the conditional probability of death in the 2nd, 3rd, 4th, and 5th years declined to 9.4%, 7.9%, 6.1%, and 5.2%, respectively. Conclusion CRS rates for patients with ovarian cancer increased with each year they survived, but this did not reach the level of ‘no excess mortality’ even 5 years after diagnosis. The largest improvements in CRS were observed in patients with poorer initial prognoses. Our findings provide updated prognosis to ovarian cancer survivors and clinicians.
Collapse
Affiliation(s)
- Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Jaeman Bae
- Department of Obstetric and Gynecology, Hanyang University, Seoul, South Korea
| | - Johyun Ha
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, National Cancer Center, Goyang, South Korea.,Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| |
Collapse
|
15
|
Schoutrop E, El-Serafi I, Poiret T, Zhao Y, Gultekin O, He R, Moyano-Galceran L, Carlson JW, Lehti K, Hassan M, Magalhaes I, Mattsson J. Mesothelin-Specific CAR T Cells Target Ovarian Cancer. Cancer Res 2021; 81:3022-3035. [PMID: 33795251 DOI: 10.1158/0008-5472.can-20-2701] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/02/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
New therapeutic options for patients with ovarian cancer are urgently needed. Therefore, we evaluated the efficacy of two second-generation mesothelin (MSLN)-directed CAR T cells in orthotopic mouse models of ovarian cancer. Treatment with CAR T cells expressing an MSLN CAR construct including the CD28 domain (M28z) significantly prolonged survival, but no persistent tumor control was observed. Despite lower response rates, MSLN-4-1BB (MBBz) CAR T cells induced long-term remission in some SKOV3-bearing mice. Tumor-infiltrating M28z and MBBz CAR T cells upregulated PD-1 and LAG3 in an antigen-dependent manner while MSLN+ tumor cells expressed the corresponding ligands (PD-L1 and HLA-DR), demonstrating that coinhibitory pathways impede CAR T-cell persistence in the ovarian tumor microenvironment. Furthermore, profiling plasma soluble factors identified a cluster of M28z- and MBBz-treated mice characterized by elevated T-cell secreted factors that had increased survival, higher CD8+ T-cell tumor infiltration, less exhausted CAR T-cell phenotypes, and increased HLA-DR expression by tumor cells. Altogether, our study demonstrates the therapeutic potential of MSLN-CAR T cells to treat ovarian cancer. SIGNIFICANCE: These findings demonstrate that MSLN-directed CAR T cells can provide antitumor immunity against ovarian cancer.
Collapse
Affiliation(s)
- Esther Schoutrop
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ibrahim El-Serafi
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Biochemistry, Faculty of Medicine, Port-Said University, Port-Said, Egypt
| | - Thomas Poiret
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ying Zhao
- Experimental Cancer Medicine, Division of Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center and Center of Allogeneic Stem Cell Transplantation (CAST), Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Okan Gultekin
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Rui He
- Experimental Cancer Medicine, Division of Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center and Center of Allogeneic Stem Cell Transplantation (CAST), Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Lidia Moyano-Galceran
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Joseph W Carlson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Kaisa Lehti
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical Laboratory Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Moustapha Hassan
- Experimental Cancer Medicine, Division of Clinical Research Center, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Research Center and Center of Allogeneic Stem Cell Transplantation (CAST), Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Isabelle Magalhaes
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
- Department of Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jonas Mattsson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
- Gloria and Seymour Epstein Chair in Cell Therapy and Transplantation, Princess Margaret Cancer Centre and University of Toronto; Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| |
Collapse
|
16
|
Song Z, Zhou Y, Bai X, Zhang D. A Practical Nomogram to Predict Early Death in Advanced Epithelial Ovarian Cancer. Front Oncol 2021; 11:655826. [PMID: 33816311 PMCID: PMC8017286 DOI: 10.3389/fonc.2021.655826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/22/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Ovarian cancer is a common gynecological malignancy, most of which is epithelial ovarian cancer (EOC). Advanced EOC is linked with a higher incidence of premature death. To date, no effective prognostic tools are available to evaluate the possibility of early death in patients with advanced EOC. Methods: Advanced (FIGO stage III and IV) EOC patients who were enrolled in the Surveillance, Epidemiology, and End Results database between 2004 and 2015 were regarded as subjects and studied. We aimed to construct a nomogram that can deliver early death prognosis in patients with advanced EOC by identifying crucial independent factors using univariate and multivariate logistic regression analyses to help deliver accurate prognoses. Results: In total, 13,403 patients with advanced EOC were included in this study. Three hundred ninety-seven out of a total of 9,379 FIGO stage III patients died early. There were 4,024 patients with FIGO stage IV, 414 of whom died early. Nomograms based on independent prognostic factors have the satisfactory predictive capability and clinical pragmatism. The internal validation feature of the nomogram demonstrated a high level of accuracy of the predicted death. Conclusions: By analyzing data from a large cohort, a clinically convenient nomogram was established to predict premature death in advanced EOC. This tool can aid clinicians in screening patients who are at higher risk for tailoring treatment plans.
Collapse
Affiliation(s)
- Zixuan Song
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yangzi Zhou
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue Bai
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dandan Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
17
|
Wang R, Xie G, Shang L, Qi C, Yang L, Huang L, Li D, Yang W. Development and validation of nomograms for epithelial ovarian cancer: a SEER population-based, real-world study. Future Oncol 2021; 17:893-906. [PMID: 33533669 DOI: 10.2217/fon-2020-0531] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aim: To develop and internally validate nomograms to predict the overall survival (OS) and the cancer-specific survival (CSS) of patients with epithelial ovarian cancer (EOC). Methods: A total of 9001 EOC patients diagnosed between 2010 and 2013 were randomly divided into the training (n = 6301) and validation (n = 2700) cohorts. Nomogram and bootstrap validation were used to assess the predictive values of the models, including discrimination, calibration and clinical benefit. Results: In the validation cohort, the concordance statistic values were 0.733 for OS and 0.747 for CSS. Calibration plots and decision curve analyses demonstrated moderate accuracy and clinical applicability. Conclusion: Nomograms were user-friendly tools for guiding clinical treatment and estimating prognosis.
Collapse
Affiliation(s)
- Ruiqi Wang
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Guilan Xie
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Li Shang
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Cuifang Qi
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China
| | - Liren Yang
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Liyan Huang
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China
| | - Danyang Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, 710061, PR China.,Department of Women's & Children's Health, Karolinska Institutet & Child & Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, 17177, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Region Stockholm, 17177, Sweden
| | - Wenfang Yang
- Department of Obstetrics & Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, PR China
| |
Collapse
|
18
|
Phinyo P, Patumanond J, Saenrungmuaeng P, Chirdchim W, Pipanmekaporn T, Tantraworasin A, Tongsong T, Tantipalakorn C. Transferability of the early-stage ovarian malignancy (EOM) score: an external validation study that includes advanced-stage and metastatic ovarian cancer. Arch Gynecol Obstet 2021; 303:1539-1548. [PMID: 33420815 DOI: 10.1007/s00404-020-05955-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: 08/18/2020] [Accepted: 12/26/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To validate the diagnostic performance of the Early-stage Ovarian Malignancy (EOM) score in an external dataset that includes advanced-stage and metastatic ovarian cancer. METHODS The data from two cross-sectional cohorts were used in the statistical analysis. The development dataset of the EOM score was collected in Phrapokklao Hospital between September 2013 and December 2017. The validation dataset was collected in Maharaj Nakorn Chiang Mai Hospital between April 2010 and March 2018. The internal and external performance of the EOM score was evaluated in terms of discrimination via area under the receiver-operating characteristic curve (AuROC) and calibration. RESULTS There were 270 and 479 patients included in the development and validation datasets, respectively. The prevalence of ovarian malignancy was 20.0% (54/270) in the development set and 30.3% (145/479) in the validation set. The EOM score had excellent discriminative ability in both the development and validation sets (AuROC 88.0 (95% CI 82.6, 93.9) and 88.0 (95% CI 84.3, 91.4), respectively). The EOM score also showed good calibration in both datasets. CONCLUSIONS The EOM score had consistent diagnostic performance in the external validation data. It is recommended for use as a triage tool in patient referrals instead of the RMI in settings where experienced sonographers are not available.
Collapse
Affiliation(s)
- Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Panprapha Saenrungmuaeng
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mahasarakham University, Maha Sarakham, Thailand
| | - Watcharin Chirdchim
- Department of Obstetrics and Gynecology, Phrapokklao Hospital, Chanthaburi, Thailand
| | - Tanyong Pipanmekaporn
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Apichat Tantraworasin
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| | - Charuwan Tantipalakorn
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
| |
Collapse
|
19
|
Plasticity in Ovarian Cancer: The Molecular Underpinnings and Phenotypic Heterogeneity. J Indian Inst Sci 2020. [DOI: 10.1007/s41745-020-00174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
20
|
Irodi A, Rye T, Herbert K, Churchman M, Bartos C, Mackean M, Nussey F, Herrington CS, Gourley C, Hollis RL. Patterns of clinicopathological features and outcome in epithelial ovarian cancer patients: 35 years of prospectively collected data. BJOG 2020; 127:1409-1420. [PMID: 32285600 DOI: 10.1111/1471-0528.16264] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Investigate the clinical landscape of ovarian carcinoma (OC) over time. DESIGN Register-based prospectively collected data. SETTING South East Scotland. SAMPLE A total of 2805 OC patients diagnosed in 1981-2015. METHODS Survival times were visualised using the Kaplan-Meier method; median survival, 5-year survival probabilities and associated restricted mean survival time analyses were used to quantify survival differences. MAIN OUTCOME MEASURES Disease-specific survival. RESULTS A significant increase in disease-specific survival (DSS) from 1981-1985 to 2011-2015 was observed (median 1.73 versus 4.23 years, P < 0.0001). Corresponding increase in progression-free survival (PFS) was not statistically significant (median 1.22 versus 1.58 years, P = 0.2568). An increase in the proportion of cases with low residual disease volume (RD) (<2 cm RD) following debulking was observed (54.0% versus 87.7%, P < 0.0001). The proportion of high grade serous (HGS) cases increased (P < 0.0001), whereas endometrioid and mucinous cases decreased (P = 0.0005 and P = 0.0002). Increases in stage IV HGS OC incidence (P = 0.0009) and stage IV HGS OC DSS (P = 0.0122) were observed. Increasing median age at diagnosis correlated with increasing Eastern Cooperative Oncology Group Performance Status (ECOG PS) over time (r = 0.86). CONCLUSIONS OC DSS has improved over the last 35 years. PFS has not significantly increased, highlighting that improvement in outcome has been limited to extending post-relapse survival. Distribution of stage at diagnosis, histological subtype and RD following debulking has changed over time, reflecting evolution in tumour classification, staging and optimal debulking definitions (from low RD to minimal or zero RD). Histology, stage, RD and ECOG PS remain reliable outcome predictors. Increasing median age at diagnosis and ECOG PS indicates demographic shifts in the clinical population. TWEETABLE ABSTRACT Significant improvement in ovarian carcinoma survival has been seen over time. Most of this improvement is due to an extension of survival following disease relapse.
Collapse
Affiliation(s)
- A Irodi
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - T Rye
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - K Herbert
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.,Oxford Cancer Centre, Churchill Hospital, Oxford, UK
| | - M Churchman
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - C Bartos
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - M Mackean
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - F Nussey
- Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK
| | - C S Herrington
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - C Gourley
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - R L Hollis
- Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
21
|
Cheng A, Lang J. Survival Analysis of Lymph Node Resection in Ovarian Cancer: A Population-Based Study. Front Oncol 2020; 10:355. [PMID: 32266140 PMCID: PMC7096485 DOI: 10.3389/fonc.2020.00355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/28/2020] [Indexed: 12/14/2022] Open
Abstract
Objective: This study aimed at comprehensively investigating the survival impact of lymphadenectomy during primary surgery in ovarian cancer. Methods: Based on the surveillance, epidemiology, and end results registry (SEER) database, we included ovarian cancer patients with detailed information between 2010 and 2016. Cox regression was performed to select prognostic factors. We conducted propensity score-weighted survival analysis to balance baseline variables, and series of stratified analyses to control main confounding factors. Results: A total of 8,652 patients were ultimately identified. Among 4,360 patients with advanced disease, lymphadenectomy did not show significant survival benefit in general (median overall survival 44 months in non-lymphadenectomy vs. 49 months in lymphadenectomy group, P = 0.055). In subgroup analysis on patients received optimal debulking, lymphadenectomy did not significantly benefit the survival outcome (median overall survival 51, 47, 60, and 58 months in the non-lymphadenectomy, 1-9 lymph nodes, 10-19 lymph nodes, ≥20 lymph nodes groups, respectively, P = 0.287). Consistent results were observed in further stratification analyses. In optimal debulking subgroup, lymph node metastasis indicated worse survival. However, when limited the number of removed lymph nodes to more than 15, there was a marginal statistical difference in overall survival (P = 0.0498) while no significant difference presented in cause-specific survival (P = 0.129) between non-lymphadenectomy, pathological negative lymph node group and positive lymph node group. And the regions of lymph metastasis were also not significantly associate with survival (P = 0.123). Among 3,266 (75%) patients with apparent early-stage disease received lymphadenectomy, 7.75% of whom were reported isolated lymph nodes metastasis and have a poorer survival (P < 0.05). Conclusions: In primary debulking for patients with advanced ovarian cancer, lymphadenectomy was not associated with more favorable outcomes when compared to no lymphadenectomy. The value of lymphadenectomy lies more in staging for apparent early disease rather than therapeutic benefit.
Collapse
Affiliation(s)
- Aoshuang Cheng
- Department of Obstetrics and Gynecology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
22
|
Neutrophil Extracellular Trap Formation Correlates with Favorable Overall Survival in High Grade Ovarian Cancer. Cancers (Basel) 2020; 12:cancers12020505. [PMID: 32098278 PMCID: PMC7072166 DOI: 10.3390/cancers12020505] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 02/06/2023] Open
Abstract
It is still a question of debate whether neutrophils, often found in the tumor microenvironment, mediate tumor-promoting or rather tumor-inhibiting activities. The present study focuses on the involvement of neutrophils in high grade serous ovarian cancer (HGSOC). Macroscopic features classify two types of peritoneal tumor spread in HGSOC. Widespread and millet sized lesions characterize the miliary type, while non-miliary metastases are larger and associated with better prognosis. Multi-omics and FACS data were generated from ascites samples. Integrated data analysis demonstrates a significant increase of neutrophil extracellular trap (NET)-associated molecules in non-miliary ascites samples. A co-association network analysis performed with the ascites data further revealed a striking correlation between NETosis-associated metabolites and several eicosanoids. The congruence of data generated from primary neutrophils with ascites analyses indicates the predominance of NADPH oxidase 2 (NOX)-independent NETosis. NETosis is associated with protein S100A8/A9 release. An increase of the S100A8/CRP abundance ratio was found to correlate with favorable survival of HGSOC patients. The analysis of additional five independent proteome studies with regard to S100A8/CRP ratios confirmed this observation. In conclusion, NET formation seems to relate with better cancer patient outcome.
Collapse
|
23
|
Wu SG, Li FY, Lei J, Hua L, He ZY, Zhou J. Histological Tumor Type is Associated with One-Year Cause-Specific Survival in Women with Stage III-IV Epithelial Ovarian Cancer: A Surveillance, Epidemiology, and End Results (SEER) Database Population Study, 2004-2014. Med Sci Monit 2020; 26:e920531. [PMID: 32008036 PMCID: PMC7011572 DOI: 10.12659/msm.920531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background The prognosis of epithelial ovarian cancer (EOC) remains poor. Cause-specific survival (CSS) is an overall survival measure of cancer survival that excludes other causes of death. This retrospective population study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate prognostic factors associated with one-year CSS in women with stage III–IV EOC between 2004–2014. Material/Methods Data from the SEER program included a cohort of patients with stage III–IV EOC between 2004–2014. Binomial logistic regression analysis, Kaplan-Meier survival curves, and multivariate Cox proportional hazards models were used for analysis of patient outcome, including the one-year CSS. Results There were 14,798 patients with stage III–IV EOC identified from SEER between 2004–2014, including 13,134 (88.8%), 892 (6.0%), 448 (3.0%), and 324 (2.2%) patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively. The overall one-year CSS was 91.2%. One-year CSS was 92.5%, 92.2%, 74.0%, and 62.5% in patients with serous, endometrioid, clear cell, and mucinous ovarian cancer, respectively (P<0.001). Histological tumor type was an independent prognostic factor of one-year CSS. Patients with mucinous EOC (HR, 8.807; 95% CI, 6.563–9.965; P<0.001) and clear cell EOC (HR, 4.581; 95% CI, 3.774–5.560; P<0.001) had a significantly lower one-year CSS compared with patients with endometrioid and serous EOC who had comparable one-year CSS (HR, 1.247; 95% CI, 0.978–1.590; P=0.075). Conclusions A retrospective population study of the SEER database between 2004–2014 identified that histological tumor type was associated with one-year CSS in women with stage III–IV EOC.
Collapse
Affiliation(s)
- San-Gang Wu
- Department of Radiation Oncology, Cancer Hospital, the First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| | - Feng-Yan Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, China (mainland)
| | - Jian Lei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| | - Li Hua
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| | - Zhen-Yu He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| | - Juan Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China (mainland)
| |
Collapse
|