TY - JOUR
T1 - Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma
T2 - A systematic review and meta-analysis of individual patient data
AU - Cohen, Paul A.
AU - Powell, Aime
AU - Böhm, Steffen
AU - Gilks, C. Blake
AU - Stewart, Colin J.R.
AU - Meniawy, Tarek M.
AU - Bulsara, Max
AU - Avril, Stefanie
AU - Brockbank, Eleanor C.
AU - Bosse, Tjalling
AU - de Azevedo Focchi, Gustavo Rubino
AU - Ganesan, Raji
AU - Glasspool, Rosalind M.
AU - Howitt, Brooke E.
AU - Kim, Hyun-Soo
AU - Lee, Jung-Yun
AU - Le, Nhu D.
AU - Lockley, Michelle
AU - Manchanda, Ranjit
AU - Mandalia, Trupti
AU - McCluggage, W. Glenn
AU - McNeish, Iain
AU - Midha, Divya
AU - Srinivasan, Radhika
AU - Tan, Yun Yi
AU - van der Griend, Rachael
AU - Yunokawa, Mayu
AU - Zannoni, Gian F.
AU - The HGSC CRS Collaborative Network
AU - Singh, Naveena
PY - 2019/8
Y1 - 2019/8
N2 - OBJECTIVE: There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.METHODS: We established an international collaboration to conduct a systematic review and meta-analysis, pooling individual patient data from 16 sites in 11 countries. Patients had stage IIIC/IV HGSC, 3-4 NACT cycles and >6-months follow-up. Random effects models were used to derive combined odds ratios in the pooled population to investigate associations between CRS and progression free and overall survival (PFS and OS).RESULTS: 877 patients were included from published and unpublished studies. Median PFS and OS were 15 months (IQR 5-65) and 28 months (IQR 7-92) respectively. CRS3 was seen in 249 patients (28%). The pooled hazard ratios (HR) for PFS and OS for CRS3 versus CRS1/CRS2 were 0·55 (95% CI, 0·45-0·66; P CONCLUSIONS: CRS3 was significantly associated with improved PFS and OS compared to CRS1/2. This validation of CRS in a real-world setting demonstrates it to be a robust and reproducible biomarker with potential to be incorporated into therapeutic decision-making and clinical trial design.
AB - OBJECTIVE: There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT.METHODS: We established an international collaboration to conduct a systematic review and meta-analysis, pooling individual patient data from 16 sites in 11 countries. Patients had stage IIIC/IV HGSC, 3-4 NACT cycles and >6-months follow-up. Random effects models were used to derive combined odds ratios in the pooled population to investigate associations between CRS and progression free and overall survival (PFS and OS).RESULTS: 877 patients were included from published and unpublished studies. Median PFS and OS were 15 months (IQR 5-65) and 28 months (IQR 7-92) respectively. CRS3 was seen in 249 patients (28%). The pooled hazard ratios (HR) for PFS and OS for CRS3 versus CRS1/CRS2 were 0·55 (95% CI, 0·45-0·66; P CONCLUSIONS: CRS3 was significantly associated with improved PFS and OS compared to CRS1/2. This validation of CRS in a real-world setting demonstrates it to be a robust and reproducible biomarker with potential to be incorporated into therapeutic decision-making and clinical trial design.
KW - Antineoplastic Agents
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Biomarkers, Tumor/analysis
KW - Carboplatin/therapeutic use
KW - Disease-Free Survival
KW - Fallopian Tube Neoplasms/drug therapy
KW - Female
KW - Humans
KW - Neoadjuvant Therapy
KW - Neoplasms, Cystic, Mucinous, and Serous/drug therapy
KW - Ovarian Neoplasms/drug therapy
KW - Treatment Outcome
U2 - 10.1016/j.ygyno.2019.04.679
DO - 10.1016/j.ygyno.2019.04.679
M3 - Review article
C2 - 31118141
SN - 0090-8258
VL - 154
SP - 441
EP - 448
JO - Gynecologic Oncology
JF - Gynecologic Oncology
IS - 2
ER -