Characterization of primary platinum resistance in an era of biologic agents and novel chemotherapeutic design

Thomas, Eric D.; Slaughter, K.N.; Gunderson, Camille C.; Perry, L.; Farrell, R.; Lauer, Jacob K.; Ding, Kai; McMeekin, D. Scott; Moore, Katherine

doi:10.1016/j.ygyno.2014.03.244

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“…Researchers like Slaughter and colleagues investigated 330 women with high-grade serous ovarian cancer and found that 25% of patients were primary platinum resistant (PPR), and the median PFS and OS of PPR patients were 4.2 and 17.8 months, respectively ( 30 ). Thomas et al had similar report, PPR manifested earlier is a bad prognosis for EOC patients, and also found that neither age, primary treatment, RD, and histology nor clinical trial was associated with PPR ( 31 ). Great progress has been made in recent years in making the mechanisms of platinum resistance clear in EOC, which mainly consist of constitutional germline mutations in BRCA1/BRCA2, epigenetic changes, and molecular anomalies of DNA repair pathways ( 32 ).…”

Section: Discussionmentioning

confidence: 86%

Clinicopathologic factors associated with short-term survival in advanced epithelial ovarian cancer

Zhou¹,

Liu

Yin³

et al. 2019

Transl. Cancer Res.

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Background Epithelial ovarian cancer (EOC) is the most lethal gynaecological malignancy, and there is a deficiency of information in the literature on the early recognition of short-term survivor (STS). This study aimed to identify the clinicopathological factors associated with STS in late-stage EOC and to establish a predictive model to identify STS. Methods Selected patients with International Federation of Gynecology and Obstetrics (FIGO) stage III or IV EOC were included in the study, and a retrospective analysis was performed. The characteristics of the patients who survived not more than 2 years (STS) were compared to those who survived at least 2 years (defined as long-term survivors, LTS). Binary logistic regression and receiver operating characteristic curve (ROC) were used to identify the independent prognostic factors associated with EOC and assess the predictive accuracy for STS. Results We identified 254 patients with advanced EOC including 57 STS and 197 LTS. A univariate analysis revealed that STS had a tendency to have omental metastasis and larger tumor size, to be platinum resistant, to have non-serous histology, to undergo suboptimal cytoreduction, to have comorbidity, and to undergo primary chemotherapy less than 6 courses. Binary regression analysis revealed that tumor size (P=0.033), platinum resistance (P<0.001), non-serous histology (P=0.048) and number of primary chemotherapy (P=0.028) were significant independent predictors of STS. A developed predictive model using these predictors had an AUC =0.831; platinum resistance alone had an AUC =0.732. Conclusions Tumor size, omental metastasis, platinum resistance, non-serous histology, and number of primary chemotherapy are predictors associated with STS when controlling other confounding factors. Tumor size and omental metastasis may be considered novel, important prognostic factors for advanced EOC patients. Platinum resistance was the most important prognosticator for STS; hence, more work is needed for the early identification and treatment of these EOC patients.

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Section: Discussionmentioning

confidence: 86%