Oncological outcomes of intraperitoneal chemotherapy in advanced ovarian cancer: BRCA mutation role.

Autor: Padilla-Iserte P; Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain. Electronic address: oncogine_lafe@gva.es., Iváñez M; Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain., Muruzabal JC; Department of Gynecologic Oncology, Hospital Universitario de Navarra, Spain., Navarro R; Department of Gynecologic Oncology, MD Anderson Cancer Center Madrid, Spain., Díaz-Feijoo B; Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain., Iacoponi S; Department of Obstetrics and Gynaecology, University Quirónsalud Madrid Hospital, Spain., García-Pineda V; Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain., Díaz C; Department of Gynecology, Valencian Institute of Oncology (IVO), Spain., Utrilla-Layna J; Department of Gynecological Oncology, Fundación Jiménez Diaz, Madrid, Spain., Gil-Moreno A; Gynecologic Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca Biomèdica en Ginecologia-VHIR, CIBERONC, Barcelona, Spain., Serra A; Department of Obstetrics and Gynecology, Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Spain., Gilabert-Estellés J; Department of Obstetrics and Gynecology, University General Hospital of Valencia Spain, Spain., Martínez Canto C; Department of Gynecology and Obstetrics, University Hospital Son Llàtzer, Mallorca, Spain., Tejerizo Á; Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación i+12, Universidad Complutense de Madrid, Spain., Lago V; Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain., Cárdenas-Rebollo JM; Department of Applied Mathematics and Statistics, CEU San Pablo University Madrid, Spain., Domingo S; Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Apr; Vol. 50 (4), pp. 108263. Date of Electronic Publication: 2024 Mar 09.
DOI: 10.1016/j.ejso.2024.108263
Abstrakt: Introduction: The knowledge of BRCA status offers a chance to evaluate the role of the intraperitoneal route in patients selected by biomolecular profiles after primary cytoreduction surgery in advanced ovarian cancer.
Materials and Methods: We performed a retrospective, multicenter study to assess oncological outcomes depending on adjuvant treatment (intraperitoneal [IP] vs intravenous [IV]) and BRCA status (BRCA1/2 mutated vs. BRCA wild type [WT]). The primary endpoint was to determine progression-free survival. The secondary objectives were overall survival and toxicity.
Results: A total of 288 women from eight centers were included: 177 in the IP arm and 111 in the IV arm, grouped into four arms according to BRCA1/2 status. Significantly better PFS was observed in BRCA1/2-mutated patients with IP chemotherapy (HR: 0.35; 95% CI, 0.16-0.75, p = 0.007), which was not present in BRCA1/2-mutated patients with IV chemotherapy (HR: 0.65; 95% CI, 0.37-1.12, p = 0.14). Significantly better OS was also observed in IP chemotherapy (HR: 0.17; 95% CI, 0.06-043, p < 0.0001), but was not present in IV chemotherapy in relation with BRCA mutation (HR: 0.52; 95% CI, 0.22-1.27, p = 0.15). For BRCA WT patients, worse survival was observed regardless of the adjuvant route used. The IP route was more toxic compared to the IV route, but toxicity was equivalent at the long-term follow-up.
Conclusion: This retrospective study suggests that BRCA status can help to offer an individualized, systematic treatment after optimal primary surgery for advanced ovarian cancer, but is limited by the small sample size. Prospective trials are essential to confirm these results.
Competing Interests: Declaration of competing interest There is no financial support, commercial association, or other type of funding source.
(© 2024 Published by Elsevier Ltd.)
Databáze: MEDLINE
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