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Pothuri B, Han S, Chase DM, Heitz F, Burger RA, Gaba L, Van Le L, Guerra E, Bender D, Korach J, Cloven N, Churruca C, Follana P, DiSilvestro P, Baurain JF, Jardon K, Pisano C, Peen U, Mäenpää J, Gupta D, Bacqué E, Li Y, Compton N, Antonova J, Monk BJ, González-Martín A. Health-related quality of life in patients with newly diagnosed advanced ovarian cancer treated with niraparib vs placebo: Results from the phase 3 randomized PRIMA/ENGOT-OV26/GOG-3012 trial. Gynecol Oncol 2024; 184:168-177. [PMID: 38325276 DOI: 10.1016/j.ygyno.2024.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To assess patient-reported health-related quality of life (HRQoL) in patients with ovarian cancer (OC) who received niraparib as first-line maintenance therapy. METHODS PRIMA/ENGOT-OV26/GOG-3012 (NCT02655016) enrolled patients with newly diagnosed advanced OC who responded to first-line platinum-based chemotherapy. Patients were randomized (2:1) to niraparib or placebo once daily in 28-day cycles until disease progression, intolerable toxicity, or death. HRQoL was assessed as a prespecified secondary end point using patient-reported responses to the European Organisation for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30), the EORTC QLQ Ovarian Cancer Module (EORTC QLQ-OV28), the Functional Assessment of Cancer Therapy-Ovarian Symptom Index (FOSI), and EQ-5D-5L questionnaires. Assessments were collected at baseline and every 8 weeks (±7 days) for 56 weeks, beginning on cycle 1/day 1, then every 12 weeks (±7 days) thereafter while the patient received study treatment. RESULTS Among trial participants (niraparib, n = 487; placebo, n = 246), PRO adherence exceeded 80% for all instruments across all cycles. Patients reported no decline over time in HRQoL measured via EORTC QLQ-C30 Global Health Status/QoL and FOSI overall scores. Scores for abdominal/gastrointestinal symptoms (EORTC QLQ-OV28) and nausea and vomiting, appetite loss, and constipation (EORTC QLQ-C30) were higher (worse symptoms) in niraparib-treated patients than placebo-treated patients; except for constipation, these differences resolved over time. Patients did not self-report any worsening from baseline of fatigue, headache, insomnia, or abdominal pain on questionnaires. CONCLUSIONS Despite some early, largely transient increases in gastrointestinal symptoms, patients with OC treated with niraparib first-line maintenance therapy reported no worsening in overall HRQoL.
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Affiliation(s)
- Bhavana Pothuri
- GOG Foundation and Departments of Obstetrics/Gynecology and Medicine, Division of Gynecologic Oncology, Laura & Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA.
| | - Sileny Han
- Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Dana M Chase
- Department of Obstetrics and Gynecology, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA
| | - Florian Heitz
- AGO Study Group, Department for Gynaecology and Gynaecologic Oncology, Kliniken Essen- Mitte, Essen, Germany; Department of Gynaecology, Charité-Universitätsmedizin Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; and Berlin Institute of Health, Berlin, Germany
| | - Robert A Burger
- Department of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lydia Gaba
- Medical Oncology Department, Hospital Clinic de Barcelona, Translational Genomics and Targeted Therapies in Solid Tumors, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Linda Van Le
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eva Guerra
- Medical Oncology Department, Breast and Gynaecological Cancer Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - David Bender
- Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, USA
| | - Jacob Korach
- Gynecologic Oncology Department, The Chaim Sheba Medical Center, Sackler Medical School, Tel Aviv University, Ramat Gan, Israel
| | | | - Cristina Churruca
- Medical Oncology Department, Hospital Universitario Donostia, San Sebastian, Spain
| | - Philippe Follana
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO) and Département D'oncologie Médicale, Centre Antoine Lacassagne, Nice, France
| | - Paul DiSilvestro
- Department of Obstetrics and Gynecology, Women and Infants Hospital/Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Jean-François Baurain
- Medical Oncology Departement, Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Kris Jardon
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC, Canada
| | - Carmela Pisano
- Department of Urology and Gynaecology, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, Italy
| | - Ulla Peen
- Herlev University Hospital, Herlev, Denmark
| | | | | | | | | | | | | | - Bradley J Monk
- HonorHealth Research Institute, University of Arizona College of Medicine, Phoenix, and Creighton University School of Medicine, Phoenix, AZ, USA
| | - Antonio González-Martín
- Medical Oncology Department and Program in Solid Tumours - CIMA, Cancer Center Clínica Universidad de Navarra, Grupo Español de Investigación en Cáncer de Ovario (GEICO), Madrid, Spain
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Thomson CA, Crane TE, Miller A, Gold MA, Powell M, Bixel K, Van Le L, DiSilvestro P, Ratner E, Lele S, Guntupalli S, Huh W, Robertson SE, Modesitt S, Casey AC, Basen-Engquist K, Skiba M, Walker J, Kachnic L, Alberts DS. Lifestyle intervention in ovarian cancer enhanced survival (LIVES) study (NRG/GOG0225): Recruitment, retention and baseline characteristics of a randomized trial of diet and physical activity in ovarian cancer survivors. Gynecol Oncol 2023; 170:11-18. [PMID: 36608382 PMCID: PMC10023359 DOI: 10.1016/j.ygyno.2022.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/16/2022] [Accepted: 12/26/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The Lifestyle Intervention for oVarian cancer Enhanced Survival (LIVES) is a national study of a combined diet and physical activity intervention for stage II-IV ovarian cancer survival, an under-represented cancer in lifestyle behavioral intervention research. Here, we present the data on recruitment, retention, and baseline demographic, clinical and lifestyle behavior characteristics of the LIVES study participants. METHODS The LIVES study (NRG Oncology/GOG 0225) is a Phase III diet plus physical activity intervention trial testing the hypothesis that ovarian cancer survivors in the lifestyle intervention will demonstrate better progression-free survival than those in the control condition. Study interventions were delivered via centralized telephone-based health coaching. Baseline descriptive statistics were computed for demographic, clinical, and lifestyle behavior characteristics. RESULTS The LIVES study exceeded its recruitment goals, enrolling 1205 ovarian cancer survivors from 195 NRG/NCORP-affiliated oncology practices across 49 states from 2012 to 2018. The mean age of enrollees was 59.6 years; the majority (69.4%) with stage III disease; 89% White, 5.5% Hispanic; 64% overweight/obese. Baseline self-reported diet showed a mean daily intake of 6.6 servings of fruit and vegetables, 62.7 fat grams, and 21.7 g of fiber. Physical activity averaged 13.0 MET-hours/week of moderate to vigorous physical activity; 50.9 h/week of sedentary time. Retention rates exceeded 88%. CONCLUSION The LIVES study demonstrates efficiency in recruiting and retaining ovarian cancer survivors in a 24-month study of diet and physical activity intervention with a primary endpoint of progression free survival that will be reported. TRIAL REGISTRATION ClinicalTrials.govNCT00719303.
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Affiliation(s)
- Cynthia A Thomson
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - Tracy E Crane
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA; Division of Medical Oncology, Miller School of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
| | - Austin Miller
- NRG Oncology, Clinical Trials Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | - Michael A Gold
- Oklahoma Cancer Specialists and Research Institute, Tulsa, OK, USA.
| | - Matthew Powell
- Washington University School of Medicine, St. Louis, MO, USA.
| | - Kristin Bixel
- Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute, Columbus, OH, USA.
| | - Linda Van Le
- University of North Carolina School of Medicine, UNC Hospitals, 101 Manning Dr, Chapel Hill, NC, USA.
| | | | - Elena Ratner
- Yale University School of Medicine, New Haven, CT, USA.
| | | | - Saketh Guntupalli
- University of Colorado Cancer Center - Anschutz Cancer Pavilion, Aurora, CO, USA.
| | - Warner Huh
- University of Alabama at Birmingham Hospital, Birmingham, AL, USA.
| | | | - Susan Modesitt
- University of Virginia, Emily Couric Clinical Cancer Center, Charlottesville, VA, USA.
| | | | - Karen Basen-Engquist
- Professor of Behavioral Science, Director of the Center for Energy Balance in Cancer Prevention & Survivorship, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Meghan Skiba
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | - Joan Walker
- University of Oklahoma, Oklahoma City, OK, USA.
| | - Lisa Kachnic
- Columbia University, Herbert Irving Comprehensive Cancer Center, New York, NY, USA.
| | - David S Alberts
- Medicine, Pharmacology, Public Health, Nutritional Sciences & BIO5, Emeritus, University of Arizona Cancer Center, Tucson, AZ, 85719, USA.
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DiSilvestro P, Banerjee S, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Oza A, González-Martín A, Aghajanian C, Bradley W, Mathews C, Liu J, McNamara J, Lowe ES, Ah-See ML, Moore KN. Overall Survival With Maintenance Olaparib at a 7-Year Follow-Up in Patients With Newly Diagnosed Advanced Ovarian Cancer and a BRCA Mutation: The SOLO1/GOG 3004 Trial. J Clin Oncol 2023; 41:609-617. [PMID: 36082969 PMCID: PMC9870219 DOI: 10.1200/jco.22.01549] [Citation(s) in RCA: 107] [Impact Index Per Article: 107.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE In SOLO1/GOG 3004 (ClinicalTrials.gov identifier: NCT01844986), maintenance therapy with the poly(ADP-ribose) polymerase inhibitor olaparib provided a sustained progression-free survival benefit in patients with newly diagnosed advanced ovarian cancer and a BRCA1 and/or BRCA2 (BRCA) mutation. We report overall survival (OS) after a 7-year follow-up, a clinically relevant time point and the longest follow-up for any poly(ADP-ribose) polymerase inhibitor in the first-line setting. METHODS This double-blind phase III trial randomly assigned patients with newly diagnosed advanced ovarian cancer and a BRCA mutation in clinical response to platinum-based chemotherapy to maintenance olaparib (n = 260) or placebo (n = 131) for up to 2 years. A prespecified descriptive analysis of OS, a secondary end point, was conducted after a 7-year follow-up. RESULTS The median duration of treatment was 24.6 months with olaparib and 13.9 months with placebo, and the median follow-up was 88.9 and 87.4 months, respectively. The hazard ratio for OS was 0.55 (95% CI, 0.40 to 0.76; P = .0004 [P < .0001 required to declare statistical significance]). At 7 years, 67.0% of olaparib patients versus 46.5% of placebo patients were alive, and 45.3% versus 20.6%, respectively, were alive and had not received a first subsequent treatment (Kaplan-Meier estimates). The incidence of myelodysplastic syndrome and acute myeloid leukemia remained low, and new primary malignancies remained balanced between treatment groups. CONCLUSION Results indicate a clinically meaningful, albeit not statistically significant according to prespecified criteria, improvement in OS with maintenance olaparib in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation and support the use of maintenance olaparib to achieve long-term remission in this setting; the potential for cure may also be enhanced. No new safety signals were observed during long-term follow-up.
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Affiliation(s)
- Paul DiSilvestro
- Program in Women's Oncology, Women & Infants Hospital, Providence, RI
- Paul DiSilvestro, MD, Women & Infants Hospital, 101 Dudley St, Providence, RI 02905; e-mail:
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Nicoletta Colombo
- University of Milan-Bicocca and Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France
| | - Alexandra Leary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris, France
- Institut Gustave-Roussy, Villejuif, France
| | - Gabe S. Sonke
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Charlie Gourley
- Cancer Research UK Scotland Center, University of Edinburgh, Edinburgh, United Kingdom
| | - Amit Oza
- Princess Margaret Cancer Center, Toronto, ON, Canada
| | - Antonio González-Martín
- Clínica Universidad de Navarra, Madrid, Spain
- Program In Solid Tumours, CIMA, Pamplona, Spain
| | | | - William Bradley
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI
| | - Cara Mathews
- Program in Women's Oncology, Women & Infants Hospital, Providence, RI
| | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA
| | - John McNamara
- Biostatistics, Oncology Biometrics, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Elizabeth S. Lowe
- Global Medicines Development, Oncology, AstraZeneca, Gaithersburg, MD
| | - Mei-Lin Ah-See
- Oncology R&D, Late-stage Development, AstraZeneca, Cambridge, United Kingdom
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DiSilvestro P, Banerjee S, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Oza A, Gonzalez Martin A, Aghajanian C, Bradley W, Mathews C, McNamara J, Lowe E, Moore K. 517O Overall survival (OS) at 7-year (y) follow-up (f/u) in patients (pts) with newly diagnosed advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) who received maintenance olaparib in the SOLO1/GOG-3004 trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Walker J, Mark B, Moore K, Tewari K, Thaker P, DiSilvestro P, Le LV, Guntupalli S, Gray H, Rose P, Alberts D, Fujiwara K, Mannel R, Aghajanian C, Copeland L, Fleming G. Long Term Survival of GOG 252 ‘Randomized Trial of Intravenous Versus Intraperitoneal Chemotherapy plus Bevacizumab in Advanced Ovarian Carcinoma: An NRG Oncology/GOG Study’ (021). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01239-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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DiSilvestro P, Colombo N, Harter P, González-Martín A, Ray-Coquard I, Coleman RL. Maintenance Treatment of Newly Diagnosed Advanced Ovarian Cancer: Time for a Paradigm Shift? Cancers (Basel) 2021; 13:5756. [PMID: 34830911 PMCID: PMC8616471 DOI: 10.3390/cancers13225756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/16/2022] Open
Abstract
Recent data have demonstrated substantial efficacy with poly (ADP-ribose) polymerase (PARP) inhibitors as treatment and/or maintenance therapy in patients with newly diagnosed advanced epithelial ovarian cancer (EOC). Here, we review efficacy and safety results from four recent Phase III trials in newly diagnosed EOC: SOLO1 (olaparib), PAOLA-1 (olaparib in combination with bevacizumab), PRIMA (niraparib), and VELIA (veliparib). The implications of these data for current clinical practice and areas for future research are discussed, including ongoing studies of targeted agents in the newly diagnosed setting. Data from SOLO1, PAOLA-1, PRIMA, and VELIA confirm the benefit of PARP inhibitors (olaparib, niraparib, veliparib) for women with newly diagnosed EOC. The greatest benefit was seen in patients with a BRCA1 and/or BRCA2 mutation or in the homologous recombination deficiency (HRD)-test positive subgroup. These four well-conducted studies have generated practice-changing data. However, deciding how to apply these results in clinical practice is challenging, and substantial differences in trial design impede cross-trial comparisons. Recent PARP inhibitor approvals (olaparib, niraparib) in the newly diagnosed EOC setting have provided new maintenance treatment options for a broader patient population. The results of these studies call for personalized medicine based on biomarker profile and other factors, including tolerability, cost considerations, and physician and patient preference. Important areas for future research include appropriate use of both BRCA mutation and HRD testing to inform magnitude of PARP inhibitor benefit as well as exploring further options for patients who are HRD-test negative and for those who become PARP inhibitor resistant.
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Affiliation(s)
- Paul DiSilvestro
- Program in Women’s Oncology, Women & Infants Hospital, Providence, RI 02905, USA
| | - Nicoletta Colombo
- IRCCS European Institute of Oncology (IEO), University of Milan-Bicocca, 20126 Milan, Italy;
| | - Philipp Harter
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen Mitte, 45136 Essen, Germany;
| | - Antonio González-Martín
- Department of Oncology, Clínica Universidad de Navarra, 28027 Madrid, Spain;
- Program in Solid Tumors, Center for Applied Medical Research (CIMA), 31008 Pamplona, Spain
| | - Isabelle Ray-Coquard
- Centre Leon Berard, Claude Bernard, Claude Bernard University, 69008 Lyon, France;
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Vergote I, Ray-Coquard I, Anderson DM, Cantuaria G, Colombo N, Garnier-Tixidre C, Gilbert L, Harter P, Hettle R, Lorusso D, Mäenpää J, Marth C, Matsumoto K, Ouwens M, Poveda A, Raspagliesi F, Rhodes K, Rubio Pérez MJ, Shapira-Frommer R, Shikama A, Sikorska M, Moore K, DiSilvestro P. Population-adjusted indirect treatment comparison of the SOLO1 and PAOLA-1/ENGOT-ov25 trials evaluating maintenance olaparib or bevacizumab or the combination of both in newly diagnosed, advanced BRCA-mutated ovarian cancer. Eur J Cancer 2021; 157:415-423. [PMID: 34597975 DOI: 10.1016/j.ejca.2021.08.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND In the absence of randomised head-to-head trials, we conducted a population-adjusted indirect treatment comparison (PA-ITC) of phase III trial data to evaluate the relative efficacy and safety of maintenance olaparib and bevacizumab alone and in combination in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation (BRCAm). METHODS An unanchored PA-ITC was performed on investigator-assessed progression-free survival (PFS) data. Individual patient data from SOLO1 (olaparib versus placebo) and from BRCA-mutated patients in PAOLA-1/ENGOT-ov25 (olaparib plus bevacizumab versus placebo plus bevacizumab) were pooled. Each arm of PAOLA-1 was weighted so that key baseline patient characteristics were similar to the SOLO1 cohort. Analyses were performed in patients with complete baseline data. Weighted Cox regression analysis was used to estimate the comparative efficacy of different maintenance therapy strategies, supplemented by weighted Kaplan-Meier analyses. RESULTS Data from SOLO1 patients (olaparib, n = 254; placebo, n = 126) were compared with data from BRCA-mutated PAOLA-1 patients (olaparib plus bevacizumab, n = 151; placebo plus bevacizumab, n = 71). Adding bevacizumab to olaparib was associated with a numerical improvement in PFS compared with olaparib alone (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.45-1.09). Statistically significant improvements in PFS were seen with olaparib alone versus placebo plus bevacizumab (HR 0.48; 95% CI 0.30-0.75), olaparib plus bevacizumab versus placebo (0.23; 0.14-0.34), and placebo plus bevacizumab versus placebo (0.65; 0.43-0.95). CONCLUSIONS Results of this hypothesis-generating PA-ITC analysis support the use of maintenance olaparib alone or with bevacizumab in patients with newly diagnosed, advanced ovarian cancer and a BRCAm.
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Affiliation(s)
- Ignace Vergote
- University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union; Belgian and Luxembourg Gynaecological Oncology Group (BGOG), Belgium, European Union.
| | - Isabelle Ray-Coquard
- Centre Léon BERARD and University Claude Bernard Lyon 1, Lyon, France; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), France
| | - Daniel M Anderson
- Metro Minnesota Community Oncology Research Consortium, St Louis Park, MN, USA
| | | | - Nicoletta Colombo
- University of Milan-Bicocca and Istituto Europeo di Oncologia IRCCS, Milan, Italy; Mario Negri Gynecologic Oncology Group (MANGO), Italy
| | - Claire Garnier-Tixidre
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), France; Institut Daniel Hollard, Grenoble, France
| | - Lucy Gilbert
- McGill University Health Centre, Montreal, Quebec, Canada
| | - Philipp Harter
- Ev. Kliniken Essen Mitte, Essen, Germany; Arbeitsgemeinschaft Gynäkologische Onkologie (AGO) Studiengruppe, Germany
| | | | - Domenica Lorusso
- Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; Multicenter Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO), Italy
| | - Johanna Mäenpää
- Tampere University and University Hospital, Tampere, Finland; Nordic Society of Gynecologic Oncology (NSGO), Finland
| | - Christian Marth
- Medical University Innsbruck, Innsbruck, Austria; AGO-Austria, Austria
| | | | | | - Andrés Poveda
- Initia Oncology, Hospital Quirónsalud, Valencia, Spain; Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain
| | | | | | - María J Rubio Pérez
- Grupo Español de Investigación en Cáncer de Ovario (GEICO), Spain; Reina Sofia Hospital, Córdoba, Spain
| | | | - Ayumi Shikama
- University of Tsukuba, Tsukuba, Japan; Gynecologic Oncology Trial and Investigation Consortium (GOTIC), Japan
| | | | - Kathleen Moore
- Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, OK, USA
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Colombo N, Moore K, Scambia G, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley WH, Kim JW, Mathews C, Liu J, Lowe ES, Bloomfield R, DiSilvestro P. Tolerability of maintenance olaparib in newly diagnosed patients with advanced ovarian cancer and a BRCA mutation in the randomized phase III SOLO1 trial. Gynecol Oncol 2021; 163:41-49. [PMID: 34353615 PMCID: PMC9555119 DOI: 10.1016/j.ygyno.2021.07.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/04/2021] [Accepted: 07/09/2021] [Indexed: 01/21/2023]
Abstract
Objectives. In the phase III SOLO1 trial (NCT01844986), maintenance olaparib provided a substantial progression-free survival benefit in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation who were in response after platinum-based chemotherapy. We analyzed the timing, duration and grade of the most common hematologic and non-hematologic adverse events in SOLO1. Methods. Eligible patients were randomized to olaparib tablets 300 mg twice daily (N = 260)or placebo (N = 131), with a 2-year treatment cap in most patients. Safety outcomes were analyzed in detail in randomized patients who received at least one dose of study drug (olaparib, n = 260; placebo, n = 130). Results. Median time to first onset of the most common hematologic (anemia, neutropenia, thrombocytopenia) and non-hematologic (nausea, fatigue/asthenia, vomiting) adverse events was <3 months in olaparibtreated patients. The first event of anemia, neutropenia, thrombocytopenia, nausea and vomiting lasted a median of <2 months and the first event of fatigue/asthenia lasted a median of 3.48 months in the olaparib group. These adverse events were manageable with supportive treatment and/or olaparib dose modification in most patients, with few patients requiring discontinuation of olaparib. Of 162 patients still receiving olaparib at month 24, 64.2% were receiving the recommended starting dose of olaparib 300 mg twice daily. Conclusions. Maintenance olaparib had a predictable and manageable adverse event profile in the newly diagnosed setting with no new safety signals identified. Adverse events usually occurred early, were largely manageable and led to discontinuation in a minority of patients.
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Affiliation(s)
- Nicoletta Colombo
- University of Milan-Bicocca and IEO European Institute of Oncology IRCCS, Milan, Italy.
| | - Kathleen Moore
- Stephenson Cancer Center at the University of Oklahoma, Oklahoma City, OK, United States
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome, Italy
| | - Ana Oaknin
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | - Alexandra Leary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Institut Gustave-Roussy, Villejuif, France
| | - Gabe S Sonke
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust, and Institute of Cancer Research, London, United Kingdom
| | - Amit Oza
- Princess Margaret Cancer Centre, Toronto, Canada
| | | | - Carol Aghajanian
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - William H Bradley
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Cara Mathews
- Women & Infants Hospital, Providence, RI, United States
| | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA, United States
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Bradley W, Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Cain T, Lowe E, DiSilvestro P. Maintenance olaparib for patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation: 5-year follow-up from SOLO1. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00694-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Friedlander M, Moore KN, Colombo N, Scambia G, Kim BG, Oaknin A, Lisyanskaya A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley WH, Liu J, Mathews C, Selle F, Lortholary A, Lowe ES, Hettle R, Flood E, Parkhomenko E, DiSilvestro P. Patient-centred outcomes and effect of disease progression on health status in patients with newly diagnosed advanced ovarian cancer and a BRCA mutation receiving maintenance olaparib or placebo (SOLO1): a randomised, phase 3 trial. Lancet Oncol 2021; 22:632-642. [PMID: 33862001 DOI: 10.1016/s1470-2045(21)00098-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND In the phase 3 SOLO1 trial, maintenance olaparib provided a significant progression-free survival benefit versus placebo in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation in response after platinum-based chemotherapy. We analysed health-related quality of life (HRQOL) and patient-centred outcomes in SOLO1, and the effect of radiological disease progression on health status. METHODS SOLO1 is a randomised, double-blind, international trial done in 118 centres and 15 countries. Eligible patients were aged 18 years or older; had an Eastern Cooperative Oncology Group performance status score of 0-1; had newly diagnosed, advanced, high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian tube cancer with a BRCA mutation; and were in clinical complete or partial response to platinum-based chemotherapy. Patients were randomly assigned (2:1) to either 300 mg olaparib tablets or placebo twice per day using an interactive voice and web response system and were treated for up to 2 years. Treatment assignment was masked for patients and for clinicians giving the interventions, and those collecting and analysing the data. Randomisation was stratified by response to platinum-based chemotherapy (clinical complete or partial response). HRQOL was a secondary endpoint and the prespecified primary HRQOL endpoint was the change from baseline in the Functional Assessment of Cancer Therapy-Ovarian Cancer Trial Outcome Index (TOI) score for the first 24 months. TOI scores range from 0 to 100 (higher scores indicated better HRQOL), with a clinically meaningful difference defined as a difference of at least 10 points. Prespecified exploratory endpoints were quality-adjusted progression-free survival and time without significant symptoms of toxicity (TWiST). HRQOL endpoints were analysed in all randomly assigned patients. The trial is ongoing but closed to new participants. This trial is registered with ClinicalTrials.gov, NCT01844986. FINDINGS Between Sept 3, 2013, and March 6, 2015, 1084 patients were enrolled. 693 patients were ineligible, leaving 391 eligible patients who were randomly assigned to olaparib (n=260) or placebo (n=131; one placebo patient withdrew before receiving any study treatment), with a median duration of follow-up of 40·7 months (IQR 34·9-42·9) for olaparib and 41·2 months (32·2-41·6) for placebo. There was no clinically meaningful change in TOI score at 24 months within or between the olaparib and placebo groups (adjusted mean change in score from baseline over 24 months was 0·30 points [95% CI -0·72 to 1·32] in the olaparib group vs 3·30 points [1·84 to 4·76] in the placebo group; between-group difference of -3·00, 95% CI -4·78 to -1·22; p=0·0010). Mean quality-adjusted progression-free survival (olaparib 29·75 months [95% CI 28·20-31·63] vs placebo 17·58 [15·05-20·18]; difference 12·17 months [95% CI 9·07-15·11], p<0·0001) and the mean duration of TWiST (olaparib 33·15 months [95% CI 30·82-35·49] vs placebo 20·24 months [17·36-23·11]; difference 12·92 months [95% CI 9·30-16·54]; p<0·0001) were significantly longer with olaparib than with placebo. INTERPRETATION The substantial progression-free survival benefit provided by maintenance olaparib in the newly diagnosed setting was achieved with no detrimental effect on patients' HRQOL and was supported by clinically meaningful quality-adjusted progression-free survival and TWiST benefits with maintenance olaparib versus placebo. FUNDING AstraZeneca and Merck Sharp & Dohme.
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Affiliation(s)
- Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, NSW, Australia.
| | - Kathleen N Moore
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
| | - Nicoletta Colombo
- University of Milan-Bicocca, Milan, Italy; Istituto Europeo di Oncologia IRCCS, Milan, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A Gemelli IRCCS, Università Cattolica, Rome, Italy
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ana Oaknin
- Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | | | - Gabe S Sonke
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Susana Banerjee
- The Royal Marsden NHS Foundation Trust, London, UK; Institute of Cancer Research, London, UK
| | - Amit Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | | | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Frédéric Selle
- Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France
| | - Alain Lortholary
- Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens (GINECO), Paris, France; Centre Catherine de Sienne Hopital privé du Confluent, Nantes, France
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11
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DiSilvestro P, Lowe ES, Bloomfield R. Reply to S. Gulia et al. J Clin Oncol 2021; 39:256. [PMID: 33326256 DOI: 10.1200/jco.20.03081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Paul DiSilvestro
- Paul DiSilvestro, MD, Women & Infants Hospital, Providence, RI; Elizabeth S. Lowe, MD, ScM, AstraZeneca, Gaithersburg, MD; and Ralph Bloomfield, MSc, AstraZeneca, Cambridge, United Kingdom
| | - Elizabeth S Lowe
- Paul DiSilvestro, MD, Women & Infants Hospital, Providence, RI; Elizabeth S. Lowe, MD, ScM, AstraZeneca, Gaithersburg, MD; and Ralph Bloomfield, MSc, AstraZeneca, Cambridge, United Kingdom
| | - Ralph Bloomfield
- Paul DiSilvestro, MD, Women & Infants Hospital, Providence, RI; Elizabeth S. Lowe, MD, ScM, AstraZeneca, Gaithersburg, MD; and Ralph Bloomfield, MSc, AstraZeneca, Cambridge, United Kingdom
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Miller DS, Filiaci VL, Mannel RS, Cohn DE, Matsumoto T, Tewari KS, DiSilvestro P, Pearl ML, Argenta PA, Powell MA, Zweizig SL, Warshal DP, Hanjani P, Carney ME, Huang H, Cella D, Zaino R, Fleming GF. Carboplatin and Paclitaxel for Advanced Endometrial Cancer: Final Overall Survival and Adverse Event Analysis of a Phase III Trial (NRG Oncology/GOG0209). J Clin Oncol 2020; 38:3841-3850. [PMID: 33078978 DOI: 10.1200/jco.20.01076] [Citation(s) in RCA: 126] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Limitations of the paclitaxel-doxorubicin-cisplatin (TAP) regimen in the treatment of endometrial cancer include tolerability and cumbersome scheduling. The Gynecologic Oncology Group studied carboplatin plus paclitaxel (TC) as a noninferior alternative to TAP. METHODS GOG0209 was a phase III, randomized, noninferiority, open-label trial. Inclusion criteria were stage III, stage IV, and recurrent endometrial cancers; performance status 0-2; and adequate renal, hepatic, and marrow function. Prior radiotherapy and/or hormonal therapy were permitted, but chemotherapy, including radiosensitization, was not. Patients were treated with doxorubicin 45 mg/m2 and cisplatin 50 mg/m2 (day 1), followed by paclitaxel 160 mg/m2 (day 2) with granulocyte colony-stimulating factor or paclitaxel 175 mg/m2 and carboplatin area under the curve 6 (day 1) every 21 days for seven cycles. The primary endpoint was overall survival (OS; modified intention to treat). Progression-free survival (PFS), health-related quality of life (HRQoL), and toxicity were secondary endpoints. RESULTS From 2003 to 2009, 1,381 women were enrolled. Noninferiority of TC to TAP was concluded for OS (median, 37 v 41 months, respectively; hazard ratio [HR], 1.002; 90% CI, 0.9 to 1.12), and PFS (median, 13 v 14 months; HR, 1.032; 90% CI, 0.93 to 1.15). Neutropenic fever was reported in 7% of patients receiving TAP and 6% of those receiving TC. Grade > 2 sensory neuropathy was recorded in 26% of patients receiving TAP and 20% receiving TC (P = .40). More grade ≥ 3 thrombocytopenia (23% v 12%), vomiting (7% v 4%), diarrhea (6% v 2%), and metabolic (14% v 8%) toxicities were reported with TAP. Neutropenia (52% v 80%) was more common with TC. Small HRQoL differences favored TC. CONCLUSION With demonstrated noninferiority to TAP, TC is the global first-line standard for advanced endometrial cancer.
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Affiliation(s)
- David S Miller
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Virginia L Filiaci
- NRG Oncology, Clinical Trial Development Division, Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Robert S Mannel
- The Peggy and Charles Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - David E Cohn
- Arthur G. James Cancer Hospital and Solove Research Institute, Ohio State University, Columbus, OH
| | | | - Krishnansu S Tewari
- Division of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA
| | | | | | | | - Matthew A Powell
- Gynecologic Oncology, Washington University School of Medicine, St Louis, MO
| | - Susan L Zweizig
- University of Massachusetts Memorial Medical Center, Worcester, MA
| | | | - Parviz Hanjani
- Hanjani Institute for Gynecologic Oncology, Abington Memorial Hospital, Abington, PA
| | - Michael E Carney
- John A. Burns School of Medicine, University of Hawaii Cancer Center, Honolulu, HI
| | - Helen Huang
- NRG Oncology, Clinical Trial Development Division, Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - David Cella
- Northwestern University Feinberg School of Medicine, Chicago, IL
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Banerjee S, Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Oza A, Martín AG, Aghajanian C, Bradley W, Holmes E, Lowe E, DiSilvestro P. 811MO Maintenance olaparib for patients (pts) with newly diagnosed, advanced ovarian cancer (OC) and a BRCA mutation (BRCAm): 5-year (y) follow-up (f/u) from SOLO1. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.950] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Tewari KS, Sill MW, Monk BJ, Penson RT, Moore DH, Lankes HA, Ramondetta LM, Landrum LM, Randall LM, Oaknin A, Leitao MM, Eisenhauer EL, DiSilvestro P, Van Le L, Pearl ML, Burke JJ, Salani R, Richardson DL, Michael HE, Kindelberger DW, Birrer MJ. Circulating Tumor Cells In Advanced Cervical Cancer: NRG Oncology-Gynecologic Oncology Group Study 240 (NCT 00803062). Mol Cancer Ther 2020; 19:2363-2370. [PMID: 32847980 DOI: 10.1158/1535-7163.mct-20-0276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/04/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022]
Abstract
To isolate circulating tumor cells (CTC) from women with advanced cervical cancer and estimate the impact of CTCs and treatment on overall survival and progression-free survival (PFS). A total of 7.5 mL of whole blood was drawn pre-cycle 1 and 36 days post-cycle 1 from patients enrolled on Gynecologic Oncology Group 0240, the phase III randomized trial that led directly to regulatory approval of the antiangiogenesis drug, bevacizumab, in women with recurrent/metastatic cervical cancer. CTCs (defined as anti-cytokeratin+/anti-CD45- cells) were isolated from the buffy coat layer using an anti-EpCAM antibody-conjugated ferrofluid and rare earth magnet, and counted using a semiautomated fluorescence microscope. The median pre-cycle 1 CTC count was 7 CTCs/7.5 mL whole blood (range, 0-18) and, at 36 days posttreatment, was 4 (range, 0-17). The greater the declination in CTCs between time points studied, the lower the risk of death [HR, 0.87; 95% confidence interval (CI), 0.79-0.95)]. Among patients with high (≥ median) pretreatment CTCs, bevacizumab treatment was associated with a reduction in the hazard of death (HR, 0.57; 95% CI, 0.32-1.03) and PFS (HR, 0.59; 95% CI, 0.36-0.96). This effect was not observed with low (< median) CTCs. CTCs can be isolated from women with advanced cervical cancer and may have prognostic significance. A survival benefit conferred by bevacizumab among patients with high pretreatment CTCs may reflect increased tumor neovascularization and concomitant vulnerability to VEGF inhibition. These data support studying CTC capture as a potential predictive biomarker.
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Affiliation(s)
| | - Michael W Sill
- NRG Oncology/Gynecologic Oncology Group, SUNY at Buffalo, Buffalo, New York.,Statistics & Data Center, SUNY at Buffalo, Buffalo, New York.,Roswell Park Cancer Institute, SUNY at Buffalo, Buffalo, New York
| | - Bradley J Monk
- University of Arizona Cancer Center and Creighton University at St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | - David H Moore
- Franciscan St. Francis Health-Indianapolis, Indianapolis, Indiana
| | - Heather A Lankes
- NRG Oncology/Gynecologic Oncology Group, SUNY at Buffalo, Buffalo, New York.,Statistics & Data Center, SUNY at Buffalo, Buffalo, New York.,Roswell Park Cancer Institute, SUNY at Buffalo, Buffalo, New York
| | | | - Lisa M Landrum
- Oklahoma University Health Science Center, Oklahoma City, Oklahoma
| | | | - Ana Oaknin
- Grupo Espanol de Investigacion en Cancer de Ovario (GEICO), Barcelona, Spain
| | - Mario M Leitao
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | | | | | - Linda Van Le
- University of North Carolina, Chapel Hill, North Carolina
| | - Michael L Pearl
- Stony Brook University Medical Center, Stony Brook, New York
| | - James J Burke
- Southeast Cancer Control Consortium CCOP, Winston-Salem, North Carolina.,Memorial University Medical Center, Savannah, Georgia
| | - Ritu Salani
- The Ohio State University Medical Center, Columbus, Ohio
| | | | - Helen E Michael
- Indiana University School of Medicine, Indianapolis, Indiana
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DiSilvestro P, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian CA, Bradley WH, Mathews CA, Liu J, Lowe ES, Bloomfield R, Moore KN. Efficacy of Maintenance Olaparib for Patients With Newly Diagnosed Advanced Ovarian Cancer With a BRCA Mutation: Subgroup Analysis Findings From the SOLO1 Trial. J Clin Oncol 2020; 38:3528-3537. [PMID: 32749942 DOI: 10.1200/jco.20.00799] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE In SOLO1, maintenance olaparib (300 mg twice daily) significantly improved progression-free survival (PFS) for patients with newly diagnosed BRCA1- and/or BRCA2-mutated advanced ovarian cancer compared with placebo (hazard ratio [HR], 0.30; 95% CI, 0.23 to 0.41; median not reached v 13.8 months). We investigated PFS in SOLO1 for subgroups of patients based on preselected baseline factors. PATIENTS AND METHODS Investigator-assessed PFS subgroup analyses of SOLO1 included clinical response after platinum-based chemotherapy (complete [CR] or partial response [PR]), surgery type (upfront or interval surgery), disease status after surgery (residual or no gross residual disease), and BRCA mutation status (BRCA1 or BRCA2). Additionally, we evaluated PFS in patients with stage III disease who underwent upfront surgery and had no gross residual disease. We also report objective response rate. RESULTS The risk of disease progression or death was reduced with olaparib compared with placebo by 69% (HR, 0.31; 95% CI, 0.21 to 0.46) and 63% (HR, 0.37; 95% CI, 0.24 to 0.58) in patients undergoing upfront or interval surgery; 56% (HR, 0.44; 95% CI, 0.25 to 0.77) and 67% (HR, 0.33; 95% CI, 0.23 to 0.46) in patients with residual or no residual disease after surgery; 66% (HR, 0.34; 95% CI, 0.24 to 0.47) and 69% in women with clinical CR or PR at baseline (HR, 0.31; 95% CI, 0.18 to 0.52); and 59% (HR, 0.41; 95% CI, 0.30 to 0.56) and 80% (HR 0.20; 95% CI, 0.10 to 0.37) in patients with a BRCA1 or BRCA2 mutation, respectively. CONCLUSION Patients with newly diagnosed advanced ovarian cancer achieve substantial benefit from maintenance olaparib treatment regardless of baseline surgery outcome, response to chemotherapy, or BRCA mutation type.
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Affiliation(s)
| | - Nicoletta Colombo
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), University of Milan-Bicocca, Milan, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A Gemelli, IRCCS, Università Cattolica, Rome, Italy
| | - Byoung-Gie Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ana Oaknin
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Michael Friedlander
- University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | | | - Anne Floquet
- Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France
| | | | - Gabe S Sonke
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Charlie Gourley
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Susana Banerjee
- The Royal Marsden National Health Service Foundation Trust and Institute of Cancer Research, London, United Kingdom
| | - Amit Oza
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | | | | | | | - Joyce Liu
- Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Kathleen N Moore
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK
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James N, Emerson J, Borgstadt A, Beffa L, Urh A, Kim K, Singh R, Moore R, DiSilvestro P, Ribeiro J. Abstract B33: Genomic analysis of immunosuppressive and proangiogenic genes in recombinant HE4 treated immune cells and implications for T-cell cytotoxicity in ovarian cancer cell co-culture. Cancer Immunol Res 2020. [DOI: 10.1158/2326-6074.tumimm18-b33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objective: To determine the effect of HE4 on expression of immune-related genes in CD8+ T cells and explore the role of HE4 in immunosuppression and angiogenesis in epithelial ovarian cancer (EOC).
Methods: Tissue HE4 levels and T cell counts were determined by immunohistochemistry (IHC). Recombinant HE4 (rHE4)-mediated gene expression in CD8+ T cells was measured by qPCR array. Cytokine levels were determined using a human cytokine array. Cell viability of ovarian cancer cells co-cultured with pooled peripheral blood mononuclear cells (PBMC) in the presence or absence of rHE4 was determined using MTS cell viability reagent. P-values were determined by unpaired 2-tailed student t test. Activation of STAT3 was evaluated by Western blot, and the interaction of STAT3 and HE4 was queried by immunoprecipitation of STAT3. Finally, HE4 and IL8 levels were measured by IHC in a microarray of human EOC and normal adjacent tissue (NAT), and levels were correlated using Spearman Rank test.
Results: Tissue HE4 levels correlated with CD8+ T cell counts in EOC. rHE4 treatment of CD8+ T cells upregulated expression of a panel of immunosuppressive and proangiogenic genes, including VEGF, HIF1A, STAT3, IDO1, FOXP3, and IL8. IL8 was most robustly upregulated (99-fold vs control). HE4 also resulted in alterations in cytokine levels in ovarian cancer cells co-cultured with PBMCs. OVCAR8 and SKOV3 ovarian cancer cell lines were treated with rHE4, and levels of phospho-STAT3—a known regulator of IL8—were measured. HE4 was found to activate STAT3 in a time-dependent manner, which occurred in the absence of a physical interaction between HE4 and STAT3. rHE4 treatment of OVCAR8 and SKOV3 cells co-cultured with PBMCs suppressed PBMC-mediated cytotoxicity. Finally, IL8 and HE4 mean levels were elevated in EOC tissue compared to NAT and significantly correlated (R=0.49332; p=0.00142).
Conclusions: HE4 upregulates expression of genes involved in promoting a proangiogenic and immunosuppressive microenvironment in EOC, which may play a role in reduced cytotoxic ability of immune cells. Upregulation of IL8 may occur via HE4 regulation of STAT3 signaling. Future directions include testing the effect of HE4 on endothelial cell angiogenesis and determining if STAT3 and VEGF inhibitors modulate HE4 suppression of immune cell cytotoxicity.
Citation Format: Nicole James, Jenna Emerson, Ashley Borgstadt, Lindsey Beffa, Anze Urh, Kyukwang Kim, Rakesh Singh, Richard Moore, Paul DiSilvestro, Jennifer Ribeiro. Genomic analysis of immunosuppressive and proangiogenic genes in recombinant HE4 treated immune cells and implications for T-cell cytotoxicity in ovarian cancer cell co-culture [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology and Immunotherapy; 2018 Nov 27-30; Miami Beach, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2020;8(4 Suppl):Abstract nr B33.
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Affiliation(s)
- Nicole James
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Jenna Emerson
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Ashley Borgstadt
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Lindsey Beffa
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Anze Urh
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Kyukwang Kim
- 2Wilmot Cancer Institute, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY
| | - Rakesh Singh
- 2Wilmot Cancer Institute, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY
| | - Richard Moore
- 2Wilmot Cancer Institute, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY
| | - Paul DiSilvestro
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
| | - Jennifer Ribeiro
- 1Division of Gynecologic Oncology, Program in Women’s Oncology, Department of Obstetrics and Gynecology, Women and Infants Hospital, Providence, RI,
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Grindstaff SL, DiSilvestro J, Hansen K, DiSilvestro P, Sung CJ, Quddus MR. COL1A1-PDGFB fusion uterine fibrosarcoma: A case report with treatment implication. Gynecol Oncol Rep 2019; 31:100523. [PMID: 31921959 PMCID: PMC6948258 DOI: 10.1016/j.gore.2019.100523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 12/19/2022] Open
Abstract
COL1A1-PDGFB gene fusion associated uterine sarcoma, so called dermatofibrosarcoma-like tumor, a recently reported entity in the uterine corpus, morphologically appears as high grade sarcoma with some features of dermatofibrosarcoma. So far only one other case has been reported in the uterine corpus and two in the uterine cervix. Identification of this gene fusion allows greater choice of targeted therapy in these patients. All the reported cases in the mullerian system are found to be CD34 positive by immunohistochemistry, a commonly used antibody in most immunohistochemistry laboratories. We would, therefore, propose routine CD34 immunohistochemical staining in all high grade uterine sarcomas which have failed other common immunohistochemical markers.
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Affiliation(s)
- Samuel L Grindstaff
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - Jessica DiSilvestro
- Program in Women's Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - Katrine Hansen
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul DiSilvestro
- Program in Women's Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - C James Sung
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - M Ruhul Quddus
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, RI, USA
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Coleman RL, Spirtos NM, Enserro D, Herzog TJ, Sabbatini P, Armstrong DK, Kim JW, Park SY, Kim BG, Nam JH, Fujiwara K, Walker JL, Casey AC, Alvarez Secord A, Rubin S, Chan JK, DiSilvestro P, Davidson SA, Cohn DE, Tewari KS, Basen-Engquist K, Huang HQ, Brady MF, Mannel RS. Secondary Surgical Cytoreduction for Recurrent Ovarian Cancer. N Engl J Med 2019; 381:1929-1939. [PMID: 31722153 PMCID: PMC6941470 DOI: 10.1056/nejmoa1902626] [Citation(s) in RCA: 178] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Secondary surgical cytoreduction in women with platinum-sensitive, recurrent epithelial ovarian, primary peritoneal, or fallopian-tube ("ovarian") cancer is widely practiced but has not been evaluated in phase 3 investigation. METHODS We randomly assigned patients with recurrent ovarian cancer who had received one previous therapy, had an interval during which no platinum-based chemotherapy was used (platinum-free interval) of 6 months or more, and had investigator-determined resectable disease (to no macroscopic residual disease) to undergo secondary surgical cytoreduction and then receive platinum-based chemotherapy or to receive platinum-based chemotherapy alone. Adjuvant chemotherapy (paclitaxel-carboplatin or gemcitabine-carboplatin) and use of bevacizumab were at the discretion of the investigator. The primary end point was overall survival. RESULTS A total of 485 patients underwent randomization, 240 to secondary cytoreduction before chemotherapy and 245 to chemotherapy alone. The median follow-up was 48.1 months. Complete gross resection was achieved in 67% of the patients assigned to surgery who underwent the procedure. Platinum-based chemotherapy with bevacizumab followed by bevacizumab maintenance was administered to 84% of the patients overall and was equally distributed between the two groups. The hazard ratio for death (surgery vs. no surgery) was 1.29 (95% confidence interval [CI], 0.97 to 1.72; P = 0.08), which corresponded to a median overall survival of 50.6 months and 64.7 months, respectively. Adjustment for platinum-free interval and chemotherapy choice did not alter the effect. The hazard ratio for disease progression or death (surgery vs. no surgery) was 0.82 (95% CI, 0.66 to 1.01; median progression-free survival, 18.9 months and 16.2 months, respectively). Surgical morbidity at 30 days was 9%; 1 patient (0.4%) died from postoperative complications. Patient-reported quality of life decreased significantly after surgery but did not differ significantly between the two groups after recovery. CONCLUSIONS In this trial involving patients with platinum-sensitive, recurrent ovarian cancer, secondary surgical cytoreduction followed by chemotherapy did not result in longer overall survival than chemotherapy alone. (Funded by the National Cancer Institute and others; GOG-0213 ClinicalTrials.gov number, NCT00565851.).
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Affiliation(s)
- Robert L Coleman
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Nick M Spirtos
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Danielle Enserro
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Thomas J Herzog
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Paul Sabbatini
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Deborah K Armstrong
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Jae-Weon Kim
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Sang-Yoon Park
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Byoung-Gie Kim
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Joo-Hyun Nam
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Keiichi Fujiwara
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Joan L Walker
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Ann C Casey
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Angeles Alvarez Secord
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Steve Rubin
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - John K Chan
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Paul DiSilvestro
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Susan A Davidson
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - David E Cohn
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Krishnansu S Tewari
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Karen Basen-Engquist
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Helen Q Huang
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Mark F Brady
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
| | - Robert S Mannel
- From the University of Texas M.D. Anderson Cancer Center, Houston (R.L.C., K.B.-E.); Women's Cancer Center of Nevada, Las Vegas (N.M.S.); NRG Oncology Statistical and Data Management Center, Roswell Park Cancer Institute, Buffalo (D.E., H.Q.H., M.F.B.), and Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (P.S.) - both in New York; the University of Cincinnati, University of Cincinnati Cancer Institute, Cincinnati (T.J.H.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore (D.K.A.); Seoul National University College of Medicine (J.-W.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine (B.-G.K.), and Asan Medical Center, University of Ulsan College of Medicine (J.-H.N.), Seoul, and the Research Institute and Hospital, National Cancer Center, Goyang (S.-Y.P.) - all in South Korea; Saitama Medical University International Medical Center, Hidaka, Japan (K.F.); the University of Oklahoma Health Sciences Center, Oklahoma City (J.L.W., R.S.M.); National Surgical Adjuvant Breast and Bowel Project/NRG Oncology, U.S. Oncology Research, and Metro-Minnesota Community Oncology Research Consortium, Minneapolis (A.C.C.); Duke Cancer Institute, Duke University Medical Center, Durham, NC (A.A.S.); Abramson Cancer Center, University of Pennsylvania, Philadelphia (S.R.); Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco (J.K.C.); Women and Infants Hospital, Providence, RI (P.D.); the University of Colorado School of Medicine, Aurora, and Denver Health Medical Center, Denver (S.A.D.); Ohio State University, Columbus (D.E.C.); and the University of California, Irvine, Orange (K.S.T.)
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Oaknin A, Moore K, Colombo N, Scambia G, Kim BG, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley W, Lowe E, Bloomfield R, DiSilvestro P. Time to second progression (PFS2) and second subsequent therapy (TSST) for patients (pts) with newly diagnosed, advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) treated with maintenance (mt) olaparib (ola): Phase III SOLO1 trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Friedlander M, Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley W, Lowe E, Hettle R, Flood E, DiSilvestro P. Patient-centred outcomes with maintenance olaparib in newly diagnosed patients with advanced ovarian cancer (OC) and a BRCA mutation (BRCAm) in the phase III SOLO1 trial to support the clinical benefit of prolongation of progression-free survival (PFS). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gourley C, Brown J, Lai Z, Lao-Sirieix P, Elks C, McGarvey H, French T, Milenkova T, Bloomfield R, Rowe P, Hodgson D, Barrett J, Moore K, DiSilvestro P, Harrington E. Analysis of tumour samples from SOLO1: Frequency of BRCA specific loss of heterozygosity (LOH) and progression-free survival (PFS) according to homologous recombination repair deficiency (HRD)-LOH score. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz250.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moore KN, Secord AA, Geller MA, Miller DS, Cloven N, Fleming GF, Wahner Hendrickson AE, Azodi M, DiSilvestro P, Oza AM, Cristea M, Berek JS, Chan JK, Rimel BJ, Matei DE, Li Y, Sun K, Luptakova K, Matulonis UA, Monk BJ. Niraparib monotherapy for late-line treatment of ovarian cancer (QUADRA): a multicentre, open-label, single-arm, phase 2 trial. Lancet Oncol 2019; 20:636-648. [DOI: 10.1016/s1470-2045(19)30029-4] [Citation(s) in RCA: 198] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/17/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
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Brooks RA, Tritchler DS, Darcy KM, Lankes HA, Salani R, Sperduto P, Guntupalli S, DiSilvestro P, Kesterson J, Olawaiye AB, Moxley K, Waggoner S, Santin A, Rader JS, Kizer NT, Thaker PH, Powell MA, Mutch DG, Birrer MJ, Goodfellow PJ. GOG 8020/210: Risk stratification of lymph node metastasis, disease progression and survival using single nucleotide polymorphisms in endometrial cancer: An NRG oncology/gynecologic oncology group study. Gynecol Oncol 2019; 153:335-342. [PMID: 30827726 DOI: 10.1016/j.ygyno.2019.02.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The ability to stratify a patient's risk of metastasis and survival permits more refined care. A proof of principle study was undertaken to investigate the relationship between single nucleotide polymorphisms (SNPs) in literature based candidate cancer genes and the risk of nodal metastasis and clinical outcome in endometrioid endometrial cancer (EEC) patients. METHODS Surgically-staged EEC patients from the Gynecologic Oncology Group or Washington University School of Medicine with germline DNA available were eligible. Fifty-four genes represented by 384 SNPs, were evaluated by Illumina Custom GoldenGate array. Association with lymph node metastases was the primary outcome. Progression-free survival (PFS) and overall survival (OS) was also evaluated. RESULTS 361 SNPs with high quality genotype data were evaluated in 337 patients with outcome data. Five SNPs in CXCR2 had an odds ratio (OR) between 0.68 and 0.70 (p-value ≤ 0.025). The A allele rs946486 in ABL had an OR of 1.5 (p-value = 0.01) for metastasis. The G allele in rs7795743 in EGFR had an OR for metastasis of 0.68 (p-value = 0.02) and hazard ratio (HR) for progression of 0.66 (p-value = 0.004). Importantly, no SNP met genome wide significance after adjusting for multiple test correcting and clinical covariates. The A allele in rs2159359 SNP in NME1 and the G allele in rs13222385 in EGFR were associated with worse OS. Both exhibited genome wide significance; rs13222385 remained significant after adjusting for prognostic clinical variables. CONCLUSION SNPs in cancer genes including rs2159359 SNP in NME1 and rs13222385 in EGFR may stratify risk in EEC and are prioritized for further investigation.
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Affiliation(s)
- Rebecca A Brooks
- Division of Gynecologic Oncology, University of California at Dabvis, Sacramento, CA, United States of America.
| | | | - Kathleen M Darcy
- Gynecologic Cancer Center of Excellence, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America; Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Inova Medical Campus, Falls Church, VA, United States of America
| | - Heather A Lankes
- Biopathology Center, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States of America; Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States of America
| | - Ritu Salani
- Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States of America
| | - Paul Sperduto
- Division of Radiation Oncology, Ridgeview Medical Center, Waconia, MN, United States of America
| | - Saketh Guntupalli
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Denver, CO, United States of America
| | - Paul DiSilvestro
- Department of Obstetrics and Gynecology, Program in Women's Oncology, Women & Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Joshua Kesterson
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Penn State College of Medicine, Milton S. Hershey Medical Center, United States of America
| | - Alexander B Olawaiye
- Department of Obstetrics, Gynecology, and Reproductive Services, University of Pittsburgh Medical Center, Magee-Women's Hospital, Pittsburgh, PA, United States of America
| | - Katherine Moxley
- Department of OB/GYN, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States of America
| | - Steven Waggoner
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, United States of America
| | - Alessandro Santin
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, United States of America
| | - Janet S Rader
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Nora T Kizer
- Department of Obstetrics and Gynecology, Springfield Clinic, Springfield, IL, United States of America
| | - Premal H Thaker
- Division of Gynecologic Oncology and Siteman Cancer Center, Washington University, St Louis, MO, United States of America
| | - Matthew A Powell
- Division of Gynecologic Oncology and Siteman Cancer Center, Washington University, St Louis, MO, United States of America
| | - David G Mutch
- Division of Gynecologic Oncology and Siteman Cancer Center, Washington University, St Louis, MO, United States of America
| | - Michael J Birrer
- Division of Hematology Oncology, The University of Alabama, Birmingham, AL, United States of America
| | - Paul J Goodfellow
- Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States of America
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Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke GS, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley W, Mathews C, Liu J, Lowe ES, Bloomfield R, DiSilvestro P. Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med 2018; 379:2495-2505. [PMID: 30345884 DOI: 10.1056/nejmoa1810858] [Citation(s) in RCA: 1592] [Impact Index Per Article: 265.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Most women with newly diagnosed advanced ovarian cancer have a relapse within 3 years after standard treatment with surgery and platinum-based chemotherapy. The benefit of the oral poly(adenosine diphosphate-ribose) polymerase inhibitor olaparib in relapsed disease has been well established, but the benefit of olaparib as maintenance therapy in newly diagnosed disease is uncertain. METHODS We conducted an international, randomized, double-blind, phase 3 trial to evaluate the efficacy of olaparib as maintenance therapy in patients with newly diagnosed advanced (International Federation of Gynecology and Obstetrics stage III or IV) high-grade serous or endometrioid ovarian cancer, primary peritoneal cancer, or fallopian-tube cancer (or a combination thereof) with a mutation in BRCA1, BRCA2, or both ( BRCA1/2) who had a complete or partial clinical response after platinum-based chemotherapy. The patients were randomly assigned, in a 2:1 ratio, to receive olaparib tablets (300 mg twice daily) or placebo. The primary end point was progression-free survival. RESULTS Of the 391 patients who underwent randomization, 260 were assigned to receive olaparib and 131 to receive placebo. A total of 388 patients had a centrally confirmed germline BRCA1/2 mutation, and 2 patients had a centrally confirmed somatic BRCA1/2 mutation. After a median follow-up of 41 months, the risk of disease progression or death was 70% lower with olaparib than with placebo (Kaplan-Meier estimate of the rate of freedom from disease progression and from death at 3 years, 60% vs. 27%; hazard ratio for disease progression or death, 0.30; 95% confidence interval, 0.23 to 0.41; P<0.001). Adverse events were consistent with the known toxic effects of olaparib. CONCLUSIONS The use of maintenance therapy with olaparib provided a substantial benefit with regard to progression-free survival among women with newly diagnosed advanced ovarian cancer and a BRCA1/2 mutation, with a 70% lower risk of disease progression or death with olaparib than with placebo. (Funded by AstraZeneca and Merck; SOLO1 ClinicalTrials.gov number, NCT01844986 .).
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Affiliation(s)
- Kathleen Moore
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Nicoletta Colombo
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Giovanni Scambia
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Byoung-Gie Kim
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Ana Oaknin
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Michael Friedlander
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Alla Lisyanskaya
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Anne Floquet
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Alexandra Leary
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Gabe S Sonke
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Charlie Gourley
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Susana Banerjee
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Amit Oza
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Antonio González-Martín
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Carol Aghajanian
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - William Bradley
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Cara Mathews
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Joyce Liu
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Elizabeth S Lowe
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Ralph Bloomfield
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
| | - Paul DiSilvestro
- From the Stephenson Cancer Center at the University of Oklahoma, Oklahoma City (K.M.); University of Milan-Bicocca, European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico, Milan (N.C.), and Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica, Rome (G.S.) - both in Italy; Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (B.-G.K.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (A. Oaknin), and M.D. Anderson Cancer Centre Madrid, Madrid (A.G.-M.) - both in Spain; University of New South Wales Clinical School, Prince of Wales Hospital, Randwick, Australia (M.F.); St. Petersburg City Oncology Dispensary, St. Petersburg, Russia (A. Lisyanskaya); Groupe d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens, Paris (A.F., A. Leary), Institut Bergonié, Comprehensive Cancer Center, Bordeaux (A.F.), and Gustave-Roussy Cancer Campus, Villejuif (A. Leary) - all in France; the Netherlands Cancer Institute, Amsterdam (G.S.S.); Cancer Research UK Edinburgh Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh (C.G.), the Royal Marsden NHS Foundation Trust and Institute of Cancer Research, London (S.B.), and AstraZeneca, Cambridge (R.B.) - all in the United Kingdom; Princess Margaret Cancer Centre, Toronto (A. Oza); Memorial Sloan Kettering Cancer Center, New York (C.A.); Froedtert and the Medical College of Wisconsin, Milwaukee (W.B.); Women and Infants Hospital, Providence, RI (C.M., P.D.); Dana-Farber Cancer Institute, Boston (J.L.); and AstraZeneca, Gaithersburg, MD (E.S.L.)
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Fiascone S, Danilack VA, Kao MJ, Cohen M, Singh K, Kalife E, Luis C, Lokich E, DiSilvestro P, Robison K. While women await surgery for type I endometrial cancer, depot medroxyprogesterone acetate reduces tumor glandular cellularity. Am J Obstet Gynecol 2018; 219:381.e1-381.e10. [PMID: 30063901 DOI: 10.1016/j.ajog.2018.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/18/2018] [Accepted: 07/24/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Multiple population-level studies have demonstrated an adverse effect of long wait times to surgery on survival for women with endometrial cancer. Other retrospective and nonrandomized prospective studies have shown that preoperative administration of depot medroxyprogesterone acetate decreases tumor glandular cellularity, which may be a surrogate marker for clinically meaningful tumor response. OBJECTIVE We sought to determine whether preoperative injection with depot medroxyprogesterone acetate decreases tumor glandular cellularity when compared to placebo injection in women awaiting hysterectomy for endometrial intraepithelial neoplasia or type I endometrial cancer, and to determine whether depot medroxyprogesterone acetate injection affects quality of life while waiting for surgery. STUDY DESIGN This was a double-blind, randomized controlled trial of 400-mg depot medroxyprogesterone acetate injection or 0.9% saline injection at the preoperative visit. Patients with recent use of progesterone analogs were excluded. A sample size of 76 patients (38 per arm) was calculated to detect a 20% difference in decreased glandular cellularity between arms. Pathologic characteristics including the primary outcome, tumor glandular cellularity, from patients' diagnostic biopsies were reviewed by 2 dedicated gynecologic pathologists and compared to posttreatment hysterectomy specimens. On the night prior to surgery, patients completed the Functional Assessment of Cancer Therapy-Endometrial Survey (Version 4) to report quality of life while waiting for surgery. In comparing characteristics between the intervention and control groups, t tests were used for continuous variables, and χ2 or Fisher exact tests were used where appropriate for categorical data. RESULTS From March 2015 through March 2016, 148 women were screened and 76 patients were enrolled. In all, 38 patients were randomized to and received depot medroxyprogesterone acetate injection and 38 were randomized to and received placebo injection. Demographics were similar between groups. Patients who received depot medroxyprogesterone acetate injection experienced a larger decrease in tumor glandular cellularity (mean change -64 [-31.8%] vs -14 [-5.5%] cells per quarter high-powered field in depot medroxyprogesterone acetate vs placebo groups, P = .002). This effect was most pronounced in women waiting ≥3 weeks for surgery. Several additional histologic and immunohistochemical markers of tumor differentiation and decreased cell proliferation were more pronounced in the depot medroxyprogesterone acetate group than in the placebo group. There were no significant differences in quality of life between groups on the Functional Assessment of Cancer Therapy-Endometrial Survey. Only 5.3% of patients who were approached declined to participate due to concerns regarding an intramuscular injection. CONCLUSION Administration of depot medroxyprogesterone acetate prior to surgery for type I endometrial cancers caused greater tumor effect than placebo injection. Injection of depot medroxyprogesterone acetate was acceptable to and well tolerated by patients. Depot medroxyprogesterone acetate may represent a meaningful bridge to surgery in women who can expect long wait times.
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Moore K, Secord A, Geller M, Miller D, Cloven N, Fleming G, Wahner Hendrickson A, Azodi M, DiSilvestro P, Oza A, Cristea M, Berek J, Chan J, Rimel B, Li Y, Luptakova K, Clark R, Matulonis U, Monk B. QUADRA: A phase II, open-label, single-arm study to evaluate niraparib in patients (pts) with relapsed ovarian cancer (ROC) in 4th or later line of therapy: Results from the tBRCAmut subset. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Moore K, Colombo N, Scambia G, Kim BG, Oaknin A, Friedlander M, Lisyanskaya A, Floquet A, Leary A, Sonke G, Gourley C, Banerjee S, Oza A, González-Martín A, Aghajanian C, Bradley W, Lowe E, Bloomfield R, DiSilvestro P. Maintenance olaparib following platinum-based chemotherapy in newly diagnosed patients (pts) with advanced ovarian cancer (OC) and a BRCA1/2 mutation (BRCAm): Phase III SOLO1 trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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DiSilvestro P, Alvarez Secord A. Maintenance treatment of recurrent ovarian cancer: Is it ready for prime time? Cancer Treat Rev 2018; 69:53-65. [PMID: 29908480 DOI: 10.1016/j.ctrv.2018.06.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/01/2018] [Accepted: 06/02/2018] [Indexed: 12/30/2022]
Abstract
Approximately 1% of women in the United States will be diagnosed with epithelial ovarian cancer (EOC) during their lifetime. It is most likely to present at a more advanced stage, requiring aggressive therapeutic measures, and most women will succumb to this illness. Due to advancements in therapy, the oncology community has begun to shift its focus to molecular targeted agents, alternative dosing schedules, and maintenance therapy. Women who achieve a response to initial adjuvant chemotherapy may be candidates for maintenance therapy, with the goal of inducing a lasting remission or prolonging the disease-free interval before recurrence. The rationale for maintenance therapy is to delay disease progression by eliminating residual, slowly-dying cancerous cells, or impeding cell turnover. This review discusses the goals of maintenance therapy for EOC with antiangiogenic agents or poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors, and reviews clinical studies that have demonstrated improvements in survival outcomes. The side-effect profiles for PARP inhibitors and the implications for preserving quality of life during maintenance therapy will also be discussed.
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Affiliation(s)
- Paul DiSilvestro
- Department of Obstetrics and Gynecology, The Warren Alpert Medical School, Brown University, Providence, RI, United States; Women & Infants' Hospital Program in Women's Oncology, Providence, RI, United States.
| | - Angeles Alvarez Secord
- Gynecology Oncology, Duke Cancer Institute, Durham, NC, United States; The Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Durham, NC, United States
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Moore KN, Secord AA, Geller MA, Miller DS, Cloven NG, Fleming GF, Wahner Hendrickson AE, Azodi M, DiSilvestro P, Oza AM, Cristea MC, Berek JS, Chan JK, Li Y, Clark R, Matulonis UA, Monk BJ. QUADRA: A phase 2, open-label, single-arm study to evaluate niraparib in patients (pts) with relapsed ovarian cancer (ROC) who have received ≥3 prior chemotherapy regimens. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5514] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Amit M. Oza
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | | | | | | | | | | | | | - Bradley J. Monk
- Division of Gynecologic Oncology, Arizona Oncology (US Oncology Network), University of Arizona College of Medicine, Phoenix Creighton University School of Medicine at St. Joseph's Hospital, Phoenix, AZ
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Matulonis UA, Filiaci VL, Huang HQ, Randall M, Kim B, DiSilvestro P, Moxley KM, O'Malley DM, Powell MA, Spirtos NM, Tewari KS, Richards W, Nakayama J, Steinhoff M, Mutch DG, Miller DS, Wenzel LB, Matei D. Analysis of patient-reported outcomes (PROs) for GOG-258, a randomized phase III trial of cisplatin and tumor volume directed irradiation followed by carboplatin and paclitaxel (Cis-RT+CP) vs. carboplatin and paclitaxel (CP) for optimally debulked, locally advanced endometrial carcinoma: A Gynecologic Oncology Group/NRG study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.5589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Byoung Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)
| | - Paul DiSilvestro
- Women and Infants Hospital in Rhode Island/The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | - Matthew A. Powell
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | | | | | - John Nakayama
- University Hospitals Cleveland Medical Center, Cleveland, OH
| | | | | | - David S. Miller
- The University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Daniela Matei
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
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Gaudet H, Ribeiro J, Khan M, Schorl C, James N, Oliver M, Singh R, DiSilvestro P, Moore R, Yano N. HE4 Promotes Events Associated with Metastatic Ovarian Cancer Via Regulation of the Extracellular Matrix. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.804.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | - Rakesh Singh
- University of Rochester Medical CenterRochesterNY
| | | | | | - Naohiro Yano
- Women & Infants HospitalProvidenceRI
- Roger Williams Medical CenterProvidenceRI
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Shinnick JK, Kumar N, Beffa L, Miller K, Friedman MA, Kalife E, DiSilvestro P, Mathews C. Management of Low-Grade Cervical Müllerian Adenosarcoma in a 14-Year-Old Girl. J Pediatr Adolesc Gynecol 2017; 30:652-654. [PMID: 28578185 DOI: 10.1016/j.jpag.2017.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 04/21/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Müllerian adenosarcomas of the cervix are composed of benign epithelial and malignant stromal components. The purpose of this report is to describe the clinical and histologic difficulties in diagnosis and to propose fertility-preserving management of low-grade lesions. CASE A 14-year-old girl presented with a friable lesion found to originate from the anterior cervical lip. Initially, clinical suspicion was for sarcoma botryoides, however, pathologic evaluation revealed a low-grade cervical Müllerian adenosarcoma. Cold knife conization was performed, and the mass was resected with clear margins. SUMMARY AND CONCLUSION Müllerian adenosarcoma of the cervix is difficult to diagnose in adolescents because of features more commonly associated with alternative diagnoses. For patients with low-grade lesions desiring future fertility, local excision with close follow-up is reasonable.
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Affiliation(s)
- Julia K Shinnick
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island.
| | - Natasha Kumar
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Lindsey Beffa
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Katherine Miller
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mary Alexandra Friedman
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Elizabeth Kalife
- Department of Pathology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Paul DiSilvestro
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Cara Mathews
- Department of Gynecologic Oncology, Women & Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island
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Randall M, Filiaci V, McMeekin D, Yashar C, Mannel R, Salani R, DiSilvestro P, Burke J, Rutherford T, Spirtos N, Cho J, Kim J, Anderson P, Brewster W, Small W, Carney M, Aghajanian C, Miller D. A Phase 3 Trial of Pelvic Radiation Therapy Versus Vaginal Cuff Brachytherapy Followed by Paclitaxel/Carboplatin Chemotherapy in Patients with High-Risk, Early-Stage Endometrial Cancer: A Gynecology Oncology Group Study. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Matei D, Filiaci VL, Randall M, Steinhoff M, DiSilvestro P, Moxley KM, Kim B, Powell MA, O'Malley DM, Spirtos NM, Tewari KS, Richards WE, Nakayama J, Mutch DG, Miller DS. A randomized phase III trial of cisplatin and tumor volume directed irradiation followed by carboplatin and paclitaxel vs. carboplatin and paclitaxel for optimally debulked, advanced endometrial carcinoma. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.5505] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5505 Background: Patients with stage III/IVA uterine cancer (UC) carry high risk of systemic and local recurrence. Chemotherapy was shown to reduce systemic recurrence, however the risk of local failure remains high. Methods: The primary endpoint of this open label, randomized phase III trial was to determine if treatment with cisplatin and volume-directed radiation followed by carboplatin and paclitaxel for 4 cycles (C-RT, experimental arm) reduces the rate of recurrence or death (i.e., increases recurrence-free survival, RFS) when compared to carboplatin and paclitaxel for 6 cycles (CT, control arm) in patients with stages III-IVA (<2 cm residual disease) or FIGO 2009 stage I/II serous or clear cell UC and positive cytology. Secondary objectives were assessment of overall survival (OS), acute and late toxicities, and quality of life. A 28.5% reduction in the rate of recurrence or death was considered significant. Treatment randomization and analysis were stratified by gross residual tumor and age. Results: Between 6/2009 and 7/2014, 813 patients were enrolled and randomized (407 C-RT and 406-CT). Of those, 733 were eligible (344 C-RT and 360 CT), and 680 received the trial intervention (333 C-RT and 347 CT). Median follow up is 47 months. Patients characteristics were balanced between arms. There were 201 (58%) > grd 3 toxicity events in the C-RT arm and 227 (63%) in the CT arm. The most common > grd 3 events were myelosupression (40% vs. 52%), gastrointestinal (13% vs. 4%), metabolic (15% vs. 19%), neurological (7% vs. 6%), infectious (4% vs. 5%). Treatment hazard ratio for RFS was 0.9 (C-RT vs. CT; CI 0.74 to 1.10). C-RT reduced the incidence of vaginal (3% vs. 7%, HR = 0.36, CI 0.16 to 0.82), pelvic and paraaortic recurrences (10% vs. 21%, HR=0.43, CI 02.8 to 0.66) compared to CT, but distant recurrences were more common with C-RT vs. CT (28% vs. 21%, HR 1.36, CI 1 to 1.86). The analysis is premature for OS comparison. Conclusions: Although C-RT reduced the rate of local recurrence compared to CT; the combined modality regimen did not increase RFS in optimally debulked, stage III/IVA UC. Clinical trial information: NCT00942357.
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Affiliation(s)
- Daniela Matei
- Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN
| | | | | | | | - Paul DiSilvestro
- Women and Infants Hospital in Rhode Island/The Warren Alpert Medical School of Brown University, Providence, RI
| | | | - Byoung Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Matthew A. Powell
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | | | | | | | - Wm Edward Richards
- Lewis Cancer and Research Pavilion at St. Joseph's/Candler, Savannah, GA
| | | | | | - David S. Miller
- The University of Texas Southwestern Medical Center, Dallas, TX
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Coleman RL, Brady MF, Herzog TJ, Sabbatini P, Armstrong DK, Walker JL, Kim BG, Fujiwara K, Tewari KS, O'Malley DM, Davidson SA, Rubin SC, DiSilvestro P, Basen-Engquist K, Huang H, Chan JK, Spirtos NM, Ashfaq R, Mannel RS. Bevacizumab and paclitaxel-carboplatin chemotherapy and secondary cytoreduction in recurrent, platinum-sensitive ovarian cancer (NRG Oncology/Gynecologic Oncology Group study GOG-0213): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2017; 18:779-791. [PMID: 28438473 DOI: 10.1016/s1470-2045(17)30279-6] [Citation(s) in RCA: 393] [Impact Index Per Article: 56.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Platinum-based chemotherapy doublets are a standard of care for women with ovarian cancer recurring 6 months after completion of initial therapy. In this study, we aimed to explore the roles of secondary surgical cytoreduction and bevacizumab in this population, and report the results of the bevacizumab component here. METHODS The multicentre, open-label, randomised phase 3 GOG-0213 trial was done in 67 predominantly academic centres in the USA (65 centres), Japan (one centre), and South Korea (one centre). Eligible patients were adult women (aged ≥18 years) with recurrent measurable or evaluable epithelial ovarian, primary peritoneal, or fallopian tube cancer, and a clinical complete response to primary platinum-based chemotherapy, who had been disease-free for at least 6 months following last infused cycle of platinum. Patients were randomly assigned (1:1) to standard chemotherapy (six 3-weekly cycles of paclitaxel [175 mg/m2 of body surface area] and carboplatin [area under the curve 5]) or the same chemotherapy regimen plus bevacizumab (15 mg/kg of bodyweight) every 3 weeks and continued as maintenance every 3 weeks until disease progression or unacceptable toxicity. Individuals who participated in both the bevacizumab objective and surgical objective (which is ongoing) were randomly assigned (1:1:1:1) to receive either of these two chemotherapy regimens with or without prior secondary cytoreductive surgery. Randomisation for the bevacizumab objective was stratified by treatment-free interval and participation in the surgical objective. The primary endpoint was overall survival, analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00565851. FINDINGS Between Dec 10, 2007, and Aug 26, 2011, 674 women were enrolled and randomly assigned to standard chemotherapy (n=337) or chemotherapy plus bevacizumab (n=377). Median follow-up at the end of the trial on Nov 5, 2014, was 49·6 months in each treatment group (IQR 41·5-62·2 for chemotherapy plus bevacizumab; IQR 40·8-59·3 for chemotherapy), at which point 415 patients had died (214 in the chemotherapy group and 201 in the chemotherapy plus bevacizumab group). Based on pretreatment stratification data, median overall survival in the chemotherapy plus bevacizumab group was 42·2 months (95% CI 37·7-46·2) versus 37·3 months (32·6-39·7) in the chemotherapy group (hazard ratio [HR] 0·829; 95% CI 0·683-1·005; p=0·056). We identified incorrect treatment-free interval stratification data for 45 (7%) patients (equally balanced between treatment groups); a sensitivity analysis of overall survival based on the audited treatment-free interval stratification data gave an adjusted HR of 0·823 (95% CI 0·680-0·996; p=0·0447). In the safety population (all patients who initiated treatment), 317 (96%) of 325 patients in the chemotherapy plus bevacizumab group had at least one grade 3 or worse adverse event compared with 282 (86%) of 332 in the chemotherapy group; the most frequently reported of these in the chemotherapy plus bevacizumab group compared with the chemotherapy group were hypertension (39 [12%] vs two [1%]), fatigue (27 [8%] vs eight [2%]), and proteinuria (27 [8%] vs none). Two (1%) treatment-related deaths occurred in the chemotherapy group (infection [n=1] and myelodysplastic syndrome [n=1]) compared with nine (3%) in the chemotherapy plus bevacizumab group (infection [n=1], febrile neutropenia [n=1], myelodysplastic syndrome [n=1], secondary malignancy [n=1]; deaths not classified with CTCAE terms: disease progression [n=3], sudden death [n=1], and not specified [n=1]). INTERPRETATION The addition of bevacizumab to standard chemotherapy, followed by maintenance therapy until progression, improved the median overall survival in patients with platinum-sensitive recurrent ovarian cancer. Although the intention-to-treat analysis for overall survival was not significant, our sensitivity analysis based on corrected treatment-free interval stratification indicates that this strategy might be an important addition to the therapeutic armamentarium in these patients. FUNDING National Cancer Institute and Genentech.
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Affiliation(s)
- Robert L Coleman
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Mark F Brady
- NRG Oncology/Gynecologic Oncology Group Statistics & Data Center, University of Buffalo, Buffalo, NY, USA
| | - Thomas J Herzog
- Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH, USA
| | - Paul Sabbatini
- Gynecologic Medical Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Deborah K Armstrong
- Departments of Obstetrics and Gynecology and Department of Medical Oncology, Johns Hopkins Kimmel Cancer Center, Baltimore, MD, USA
| | - Joan L Walker
- Department of Obstetrics and Gynecology, The University of Oklahoma, Oklahoma City, OK, USA
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwayn University School of Medicine, Seoul, South Korea
| | - Keiichi Fujiwara
- Department of Obstetrics and Gynecology, Saitama Medical University International Medical Center, Hidaka-Shi, Japan
| | - Krishnansu S Tewari
- Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, CA, USA
| | - David M O'Malley
- Department of Obstetrics and Gynecology, The Ohio State University, James Cancer Hospital, Columbus, OH, USA
| | - Susan A Davidson
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine and Denver Health Medical Center, Denver, CO, USA
| | - Stephen C Rubin
- Department of Obstetrics and Gynecology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Paul DiSilvestro
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Providence, RI, USA
| | - Karen Basen-Engquist
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Helen Huang
- NRG Oncology/Gynecologic Oncology Group Statistics & Data Center, University of Buffalo, Buffalo, NY, USA
| | - John K Chan
- Gynecologic Cancer Program, California Pacific-Palo Alto Medical Foundation, Sutter Research Institute, San Francisco, CA, USA
| | | | | | - Robert S Mannel
- Department of Obstetrics and Gynecology, The University of Oklahoma, Oklahoma City, OK, USA
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Ng CS, Zhang Z, Lee SI, Marques HS, Burgers K, Su F, Bauza J, Mannel RS, Walker JL, Huh WK, Rubin SC, DiSilvestro P, Martin LP, Chan JK, Bookman MA, Coleman RL, Lee TY. CT Perfusion as an Early Biomarker of Treatment Efficacy in Advanced Ovarian Cancer: An ACRIN and GOG Study. Clin Cancer Res 2017; 23:3684-3691. [PMID: 28174234 DOI: 10.1158/1078-0432.ccr-16-1859] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/05/2017] [Accepted: 01/10/2017] [Indexed: 11/16/2022]
Abstract
Purpose: ACRIN 6695 was a feasibility study investigating whether CT perfusion (CTP) biomarkers are associated with progression-free survival (PFS) at 6 months (PFS-6) in patients with advanced ovarian cancer who were treated with carboplatin and either dose-dense (weekly) or conventional (3-weekly) paclitaxel, with optional bevacizumab in the prospective phase III GOG-0262 trial.Experimental Design: ACRIN 6695 recruited participants with residual disease after primary cytoreductive surgery or planned interval cytoreduction following neoadjuvant therapy, to undergo CTP studies before (T0), 3 weeks (T1), and 4 weeks (T2) after chemotherapy initiation. Tumor blood flow (BF) and blood volume (BV) were derived with commercial software. Fisher exact tests assessed the associations of CTP biomarkers changes from T0 to T2 dichotomized at zero with PFS-6 and overall radiographic response rate, while Cox regression assessed the associations between CTP biomarker changes and PFS and overall survival (OS). Bonferroni correction was used to account for multiple comparisons.Results: Seventy-six of 120 enrolled patients from 19 centers were evaluable with a median age of 61 years. BV increase was significantly associated with lower chance of PFS-6 (P = 0.028), while BF achieves borderline significance (P = 0.053). In addition, BF increase was associated with shorter PFS (HR 2.9, 95% CI, 1.3-6.4, P = 0.008) and remained significant after adjusting for age, change in tumor volume, and surgery status (P = 0.007). Neither BF nor BV changes were significantly associated with treatment response rate or OS.Conclusions: Early CTP biomarkers measurement may provide early prognostic information for PFS in newly diagnosed ovarian cancer. Clin Cancer Res; 23(14); 3684-91. ©2017 AACR.
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Affiliation(s)
- Chaan S Ng
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Susanna I Lee
- Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Feng Su
- Robarts Research Institute, London, Ontario
| | | | - Robert S Mannel
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Joan L Walker
- University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | | | - Paul DiSilvestro
- Women and Infants Hospital, Brown University, Providence, Rhode Island
| | | | | | | | - Robert L Coleman
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ting-Yim Lee
- Robarts Research Institute, London, Ontario. .,Lawson Health Research Institute, London, Ontario
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Atri M, Zhang Z, Dehdashti F, Lee SI, Marques H, Ali S, Koh WJ, Mannel RS, DiSilvestro P, King SA, Pearl M, Zhou X, Plante M, Moxley KM, Gold M. Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial. Radiology 2017; 283:450-459. [PMID: 28051912 PMCID: PMC5410939 DOI: 10.1148/radiol.2016160200] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To assess the diagnostic accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) combined with diagnostic contrast material-enhanced computed tomography (CT) in detecting lymph node (LN) metastasis in high-risk endometrial cancer. Materials and Methods This prospective multicenter HIPAA-compliant study had institutional review board approval, and all participants gave written informed consent. Data were accrued between January 2010 and June 2013. Patients underwent PET/CT and pelvic and abdominal lymphadenectomy. Two hundred seven of 215 enrolled patients had PET/CT and pathologic examination results for the abdomen and pelvis. Mean patient age was 62.7 years ± 9.6 (standard deviation). Data in all 23 patients with a positive abdominal examination and in 26 randomly selected patients with a negative abdominal examination were used for this central reader study. Seven independent blinded readers reviewed diagnostic CT and PET/CT results in different sessions 1 month apart. Accuracy was calculated at the participant level, correlating abdominal (right and left para-aortic and common iliac) and pelvic (right and left external iliac and obturator) LN regions with pathologic results, respecting laterality. Reader-average sensitivities, specificities, and areas under the receiver operating characteristic curve (AUCs) of PET/CT and diagnostic CT were compared. Power calculation was for sensitivity and specificity in the abdomen. Results Sensitivities of PET/CT versus diagnostic CT for the detection of LN metastasis were 0.65 (95% confidence interval [CI]: 0.57, 0.72) versus 0.50 (95% CI: 0.43, 0.58) (P = .01) in the abdomen and 0.65 (95% CI: 0.57, 0.72) versus 0.48 (95% CI: 0.41, 0.56) (P = .004) in the pelvis. Corresponding specificities were 0.88 (95% CI: 0.83, 0.92) versus 0.93 (95% CI: 0.89, 0.96) (P = .11) and 0.93 (95% CI: 0.86, 0.96) versus 0.89 (95% CI: 0.82, 0.94) (P = .27), and AUCs were 0.78 (95% CI: 0.66, 0.89) versus 0.74 (95% CI: 0.63, 0.86) (P = .39) and 0.82 (95% CI: 0.71, 0.92) versus 0.73 (95% CI: 0.63, 0.84) (P = .02). Conclusion FDG PET/CT has satisfactory diagnostic accuracy in the detection of abdominal LN metastasis in high-risk endometrial cancer. Compared with diagnostic CT alone, addition of PET to diagnostic CT significantly increased sensitivity in both the abdomen and pelvis while maintaining high specificity. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Mostafa Atri
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Zheng Zhang
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Farrokh Dehdashti
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Susanna I Lee
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Helga Marques
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Shamshad Ali
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Wui-Jin Koh
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Robert S Mannel
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Paul DiSilvestro
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Stephanie A King
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Michael Pearl
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - XunClare Zhou
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Marie Plante
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Katherine M Moxley
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
| | - Michael Gold
- From the Department of Medical Imaging, NCSB 1C569 Toronto General Hospital, University of Toronto, University Health Network, 585 University Ave, Toronto, ON, Canada M5G 2N2 (M.A.); Center for Statistical Sciences, Brown University, Providence, RI (F.D., H.M.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.D.); Department of Radiology, Massachusetts General Hospital, Boston, Mass (S.I.L.); Roswell Park Cancer Institute, Buffalo, NY (S.A.); Department of Radiation Oncology, University of Washington Medical Center, Seattle, Wash (W.J.K.); University of Oklahoma Health Sciences Center, Oklahoma City, Okla (R.S.M., K.M.M.); Department of Gynecologic Oncology, Women and Infants Hospital, Providence, RI (P.D.); Seattle Cancer Care Alliance, Seattle, Wash (S.A.K.); School of Medicine, Stony Brook University Health Sciences Center, Stony Brook, NY (M.P.); Department of Gynecologic Oncology, University of Connecticut School of Medicine Hartford HealthCare Cancer Institute at the Hospital of Central Connecticut, New Britain, Conn (X.C.Z.); Department of Obstetrics and Gynecology, Laval University, Quebec City, Quebec, Canada (M.P.); and Department of Gynecologic Oncology, Tulsa Cancer Institute, Tulsa, Okla (M.G.)
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Atri M, Zhang Z, Dehdashti F, Lee SI, Ali S, Marques H, Koh WJ, Moore K, Landrum L, Kim JW, DiSilvestro P, Eisenhauer E, Schnell F, Gold M. Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN6671/GOG0233 trial. Gynecol Oncol 2016; 142:413-9. [PMID: 27178725 DOI: 10.1016/j.ygyno.2016.05.002] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 05/04/2016] [Accepted: 05/05/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess if FDG PET combined with diagnostic CT improves diagnostic CT accuracy to detect lymph node (LN) metastasis in advanced cervical cancer. METHODS A prospective HIPAA compliant ACRIN/GOG multicenter trial was conducted. Patients underwent concurrent diagnostic contrast-enhanced CT (DCT) and PET and pelvic/abdominal lymphadenectomy. Seven independent blinded readers reviewed PET-DCT and DCT one-month apart. Reference standard was surgically removed LN pathology. Accuracy values were calculated at participant level, correlating abdominal (right and left para-aortic/common iliac) and pelvic (right and left external iliac/obturator) LN regions with pathology, respecting laterality. Reader average sensitivities/specificities of PET-DCT vs. DCT were compared with generalized linear mixed models, and AUCs with Obuchowski's method. RESULTS One hundred fifty-three patients had PET-DCT and pathology. Forty-three of 153 patients had metastasis to abdominal LNs. Sample size calculation required review of the first 40 abdominal positive and 40 randomly selected abdominal negative studies. Patients were 24 to 74years (48.9±10.6) old. Mean sensitivities of PET-DCT/DCT for detection of LN metastasis in abdomen were 0.50 (CI: 0.44, 0.56) and 0.42 (CI: 0.36, 0.48) (p=0.052) and in pelvis 0.83 (CI: 0.78, 0.87) and 0.79 (CI: 0.73, 0.83) (p=0.15). Corresponding specificities were 0.85 (CI: 0.80, 0.89) and 0.89 (CI: 0.84, 0.92) (p=0.21) and 0.63 (CI: 0.54, 0.70) and 0.62 (CI: 0.53, 0.69) (p=0.83). Mean AUC values were 0.70 (CI: 0.61, 0.79) and 0.68 (CI: 0.59, 0.77) (p=0.43) and 0.80 (CI: 0.71, 0.88) and 0.76 (CI: 0.67, 0.85) (p=0.21) respectively. CONCLUSION Addition of PET to DCT resulted in statistically borderline increase in sensitivity to detect LN metastasis in abdomen in advanced cervical cancer.
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Affiliation(s)
| | | | | | | | | | | | | | - Kathleen Moore
- University of Oklahoma Health Science Center, United States
| | - Lisa Landrum
- University of Oklahoma Health Science Center, United States
| | - Jae Weon Kim
- Seoul National University College of Medicine, Republic of Korea
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Gonzalez-Martin A, Backes FJ, Baumann KH, Chase DM, Fehr MK, Coleman RL, Freyer G, DiSilvestro P, Lavie O, Herzog TJ, Lorusso D, Moore KN, Mirza MR, O'Cearbhaill RE, Vergote I, Pothuri B, Balser J, Agarwal S, Monk BJ. A randomized, double-blind phase III trial of niraparib maintenance treatment in patients with HRD+ advanced ovarian cancer after response to front-line platinum-based chemotherapy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.tps5606] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | - Ofer Lavie
- ISGO & Technion University, Haifa, Israel
| | | | - Domenica Lorusso
- MITO/MaNGO & Fondazione IRCCS National Cancer Institute, Milan, Italy
| | | | - Mansoor Raza Mirza
- NSGO & Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
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40
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Occhiogrosso RH, Steinhoff M, Raker C, Has P, DiSilvestro P. Adequacy of surgical staging to predict survival in early stage ovarian cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
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41
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Occhiogrosso RH, Steinhoff M, Has P, Raker C, DiSilvestro P. Impact of chemotherapy on survival for low risk versus high risk early stage ovarian cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e17066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
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42
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Lokich E, Palisoul M, Romano N, Craig Miller M, Robison K, Stuckey A, DiSilvestro P, Mathews C, Granai CO, Lambert-Messerlian G, Moore RG. Assessing the risk of ovarian malignancy algorithm for the conservative management of women with a pelvic mass. Gynecol Oncol 2015; 139:248-52. [PMID: 26364809 DOI: 10.1016/j.ygyno.2015.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 09/05/2015] [Accepted: 09/08/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the use of as an aid in the identification of women who can safely undergo conservative, non-surgical management. METHODS All patients referred to the Program in Women's Oncology for surgery with a pelvic mass are evaluated at a prospective multidisciplinary tumor board (TB) where ROMA and imaging are used for management recommendations. This study evaluated women presented to TB with a pelvic mass between 2009 and 2013 who had either surgical or conservative management. RESULTS Of the 498 patients assessed, 392 (79%) had benign disease, 22 (4%) had LMP tumors, 28 (6%) had stage I-II epithelial ovarian cancer (EOC), 36 (7%) had stage III-IV EOC and 20 (4%) had non-EOC. Using clinical assessment in conjunction with ROMA, the TB recommended observation in 188 (37.8%) women. All patients diagnosed with an invasive malignancy were recommended for surgery by the TB. In the 315 patients managed surgically, 212 were found to have benign disease and 84 women were diagnosed with an invasive malignancy. The sensitivity for the initial TB recommendations using ROMA in conjunction with clinical judgment for detecting malignancy was 100% with a specificity of 47.7% and a NPV of 100%. When including low malignant potential tumors the sensitivity was 99.1%. For stage I-IV EOC ROMA alone had a sensitivity of 95.3%. CONCLUSIONS ROMA in conjunction with clinical assessment can safely identify women for conservative management.
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Affiliation(s)
- Elizabeth Lokich
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Marguerite Palisoul
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Nicole Romano
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - M Craig Miller
- Consulting Statistician, Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Katina Robison
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Ashley Stuckey
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Paul DiSilvestro
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Cara Mathews
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - C O Granai
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Geralyn Lambert-Messerlian
- Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA; Department of Pathology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Richard G Moore
- Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA; Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA.
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Lee TY, Ng CS, Zhang Z, Lee S, Marques H, Burgers K, Su F, Bauza J, Mannel RS, Walker JL, Huh WK, Rubin SC, DiSilvestro P, Martin LP, Chan JK, Bookman MA, Coleman RL. CT perfusion as an early biomarker of treatment efficacy in advanced ovarian cancer: An ECOG-ACRIN and NRG GOG study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Ting-Yim Lee
- Lawson Health Research Institute, London, ON, Canada
| | - Chaan S. Ng
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Kyle Burgers
- Robarts Research Institute, Western University, London, ON, Canada
| | - Feng Su
- Robarts Research Institute, Western University, London, England
| | | | | | | | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
| | | | - John K. Chan
- California Pacific / Palo Alto Medical Foundation, Sutter Research Institute, San Francisco, CA
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Atri M, Zhang Z, Dehdashti F, Koh WJ, Ali S, Mannel RS, Moxley K, DiSilvestro P, Pearl M, King SDW, Plante M, Zhou X, Gold M. Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in high risk endometrial cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Farrokh Dehdashti
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | | | | | | | - Katherine Moxley
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | | | | | - Michael Gold
- Vanderbilt University Medical Center, Nashville, TN
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Dizon DS, Brady WE, Lankes HA, Jandial DA, Howell SB, Schilder RJ, Beumer JH, Christner SM, Strychor S, Powell MA, Hagemann AR, Moore KN, Walker JL, DiSilvestro P, Fracasso PM. Results of a phase I pharmacokinetic study of intraperitoneal bortezomib (B) and carboplatin (C) in patients with persistent or recurrent ovarian cancer (OC): An NRG/Gynecologic Oncology Group study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Matthew A. Powell
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Andrea R. Hagemann
- Washington University School of Medicine and Siteman Cancer Center, St. Louis, MO
| | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
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46
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Thaker PH, Brady WE, Lankes HA, Cohn DE, Aghajanian C, Mutch DG, Mannel RS, Bell-McGuinn KM, DiSilvestro P, Jelovac D, Carter JS, Salani R. A limited access phase I trial of paclitaxel, cisplatin and ABT-888 in the treatment of advanced, persistent, or recurrent carcinoma of the cervix: An NRG/GOG study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5600] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Carol Aghajanian
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY
| | | | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
| | | | | | - Ritu Salani
- The Ohio State University Wexner Medical Center, Columbus, OH
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47
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Atri M, Zhang Z, Dehdashti F, Lee S, Ali S, Koh WJ, Moore KN, Landrum LM, Kim JW, DiSilvestro P, Eisenhauer EL, Schnell FM, Gold M. Utility of PET-CT vs CT alone to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Farrokh Dehdashti
- Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO
| | | | | | | | - Kathleen N. Moore
- Peggy and Charles Stephenson Oklahoma Cancer Center, Oklahoma City, OK
| | | | | | - Paul DiSilvestro
- Women and Infants Hospital/The Warren Alpert Medical School of Brown University, Providence, RI
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Garcia DO, Crane T, Basen-Engquist K, Alberts D, Hartz V, Kendrick JE, Mannel RS, Van Le L, DiSilvestro P, Schnell F, Thomson CA. Physical Activity Levels Among Ovarian Cancer Survivors. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000478423.79482.1a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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49
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Urh A, Robison K, Raker C, Steinhoff M, DiSilvestro P, McCourt C, Mathews C, Stuckey A, Granai C, Moore RG. Evaluation of reliability and the predictive value of ICG directed SLN dissection in women with endometrial and cervical cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2014.11.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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50
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Bregar A, Cronin B, Luis C, DiSilvestro P, Schechter S, Pisharodi L, Raker C, Clark M, Robison K. Increased prevalence of abnormal anal cytology and high risk HPV in women with a history of lower genital tract neoplasia compared to women without a history of lower genital tract neoplasia. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2014.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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