bims-ovdlit Biomed News
on Ovarian cancer: early diagnosis, liquid biopsy and therapy
Issue of 2022‒07‒03
seven papers selected by
Lara Paracchini
Humanitas Research

  1. Ann Oncol. 2022 Jun 27. pii: S0923-7534(22)01740-9. [Epub ahead of print]
      BACKGROUND: In the SOLO2 trial (ENGOT Ov-21; NCT01874353), maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer (PSROC) and BRCA mutation significantly improved progression-free survival (PFS) and prolonged overall survival (OS). Following disease progression on olaparib, efficacy of subsequent chemotherapy remains unknown.PATIENTS AND METHODS: We conducted post-hoc hypothesis-generating analysis of SOLO-2 data to determine the efficacy of different chemotherapy regimens following RECIST disease progression in patients who received olaparib or placebo. We evaluated time to second progression (TTSP) calculated from the date of RECIST progression to next progression/death.
    RESULTS: The study population comprised 147 patients who received chemotherapy as their first subsequent treatment after RECIST progression. Of these, 69 (47%) and 78 (53%) were originally randomized to placebo and olaparib arms, respectively. In the placebo-treated cohort, 27/69 and 42/69 received non-platinum and platinum-based chemotherapy, respectively, compared with 24/78 and 54/78, respectively, in the olaparib-treated cohort. Among patients treated with chemotherapy (N = 147), TTSP was significantly longer in the placebo than olaparib arm: 12.1 vs. 6.9 months (hazard ratio [HR] 2.17; 95% CI 1.47-3.19). Similar result was obtained on multivariable analysis adjusting for prognostic factors at RECIST progression (HR 2.13; 95% CI 1.41-3.22). Among patients treated with platinum-based chemotherapy (N = 96), TTSP was significantly longer in the placebo arm: 14.3 vs. 7.0 months (HR 2.89; 95% CI 1.73-4.82). Conversely, among patients treated with non-platinum-based chemotherapy (N = 51), the TTSP was comparable in the placebo and olaparib arms: 8.3 vs. 6.0 months (HR 1.58; 95% CI 0.86-2.90).
    CONCLUSION: Following progression from maintenance olaparib in the recurrent setting, the efficacy of platinum-based subsequent chemotherapy seems to be reduced in BRCA1/2 mutated patients with PSROC compared to patients not previously receiving PARPi. The optimal strategy for patients who relapse after PARP inhibitors is an area of ongoing research.
    Keywords:  BRCA mutation; PARP inhibitor resistance; relapsing ovarian cancer
  2. Nat Cancer. 2022 Jun;3(6): 723-733
    MSK MIND Consortium
      Patients with high-grade serous ovarian cancer suffer poor prognosis and variable response to treatment. Known prognostic factors for this disease include homologous recombination deficiency status, age, pathological stage and residual disease status after debulking surgery. Recent work has highlighted important prognostic information captured in computed tomography and histopathological specimens, which can be exploited through machine learning. However, little is known about the capacity of combining features from these disparate sources to improve prediction of treatment response. Here, we assembled a multimodal dataset of 444 patients with primarily late-stage high-grade serous ovarian cancer and discovered quantitative features, such as tumor nuclear size on staining with hematoxylin and eosin and omental texture on contrast-enhanced computed tomography, associated with prognosis. We found that these features contributed complementary prognostic information relative to one another and clinicogenomic features. By fusing histopathological, radiologic and clinicogenomic machine-learning models, we demonstrate a promising path toward improved risk stratification of patients with cancer through multimodal data integration.
  3. ACS Biomater Sci Eng. 2022 Jun 28.
      The leading cause of gynecological cancer-related morbidity and mortality is ovarian cancer (OC), which is dubbed a silent killer. Currently, OC is a target of intense biomarker research, because it is often not discovered until the disease is advanced. The goal of OC research is to develop effective tests using biomarkers that can detect the disease at the earliest stages, which would eventually decrease the mortality, thereby preventing recurrence. Therefore, there is a pressing need to revisit the existing biomarkers to recognize the potential biomarkers that can lead to efficient predictors for the OC diagnosis. This Perspective covers an update on the currently available biomarkers used in the triaging of OC to gain certain insights into the potential role of these biomarkers and their estimation that are crucial to the understanding of neoplasm progression, diagnostics, and therapy.
    Keywords:  CA125; HE4; RMI; ROMA; biomarker; electrochemical detection; ovarian cancer
  4. Nature. 2022 Jun;606(7916): 1036-1038
    Keywords:  Computational biology and bioinformatics; Imaging; Transcriptomics