Prognostic nomogram to predict progression-free survival in patients with platinum-sensitive recurrent ovarian cancer

Abstract

Background:Patients with platinum-sensitive recurrent ovarian cancer are a heterogeneous group, and it is not possible to accurately predict the progression-free survival (PFS) in these patients. We developed and validated a nomogram to help improve prediction of PFS in patients treated with platinum-based chemotherapy.Methods:The nomogram was developed in a training cohort (n=955) from the CALYPSO trial and validated in the AGO-OVAR 2.5 Study (n=340). The proportional-hazards model (nomogram) was based on pre-treatment characteristics.Results:The nomogram had a concordance index (C-index) of 0.645. Significant predictors were tumour size platinum-chemotherapy-free interval, CA-125, number of organ metastatic sites and white blood count. When the nomogram was applied without CA-125 (CA-125 was not available in validation cohort), the C-indices were 0.624 (training) and 0.594 (validation). When classification was based only on the platinum-chemotherapy-free interval, the indices were 0.571 (training) and 0.560 (validation). The calibration plot in the validation cohort based on four predictors (without CA-125) suggested good agreement between actual and nomogram-predicted 12-month PFS probabilities.Conclusion:This nomogram, using five pre-treatment characteristics, improves prediction of PFS in patients with platinum-sensitive ovarian cancer having platinum-based chemotherapy. It will be useful for the design and stratification of patients in clinical trials and also for counselling patients.

A Dendritic Cell Vaccine Pulsed with Autologous Hypochlorous Acid-Oxidized Ovarian Cancer Lysate Primes Effective Broad Antitumor Immunity: From Bench to Bedside

“…Both subjects demonstrated a PFS2 > PFS1 in response to OCDC vaccination as second-line therapy following relapse from first-line therapy. The comparison of second versus first PFS is important in assessing studies of novel chemotherapy or immunologic treatment strategies for patients with relapsed disease including ovarian cancers, and is used to model second response based on first-response duration (31) and interpret the clinical efficacy of second-line therapies (32). Especially interesting is the durable remission in S3, whom after two recurrences remains to date in remission for a total of 44 months, of which 24 months on no additional therapy since the last vaccine.…”

Quantitative metabolic parameters measured on F-18 FDG PET/CT predict survival after relapse in patients with relapsed epithelial ovarian cancer

“…Initial response rates to standard primary treatments, including cytoreductive surgery and platinum-based combined chemotherapy, are approximately 80%, but most patients with advanced disease relapse within 2 years [2]. Relapse of epithelial ovarian cancer (EOC) occurs in a heterogeneous group of patients, with a wide variation in progression-free survival ranging from a few weeks to N3 years [3].…”

GALNT14 genotype, α-fetoprotein and therapeutic side effects predict post-chemotherapy survival in patients with advanced hepatocellular carcinoma

“…However, it was also demonstrated that there is an association between chemotherapy-induced myelotoxicity and patient outcome in a number of malignancies, including lung, breast, gastric, ovarian and colorectal cancer (30)(31)(32)(33)(34)(35)(36)(37)(38). A meta-analysis of 13 trials on various types of cancers (n=9,528) demonstrated a 31% reduction in the mortality risk for patients with a higher grade of neutropenia or leukopenia, compared to patients with lower-grade or no cytopenia (39).…”