Histopathologic response to neoadjuvant chemotherapy as a prognostic biomarker in tubo-ovarian high-grade serous carcinoma: updated Chemotherapy Response Score (CRS) results
| Autor: | Asma Faruqi, Ian Said, Steffen Böhm, Elly Brockbank, Nhu D. Le, Blake Gilks, Rekha Wuntakal, Naveena Singh, Michelle Lockley, Arjun Jeyarajah |
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| Rok vydání: | 2018 |
| Předmět: |
Oncology
0303 health sciences medicine.medical_specialty Chemotherapy Serous carcinoma business.industry medicine.medical_treatment Obstetrics and Gynecology Cancer medicine.disease Debulking 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Cohort medicine Biomarker (medicine) Stage (cooking) Ovarian cancer business 030304 developmental biology |
| Zdroj: | International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. 29(2) |
| ISSN: | 1525-1438 |
| Popis: | ObjectiveThe Chemotherapy Response Scoring (CRS) system was developed to enable reproducible reporting of histologic tumor response in interval debulking specimens following neoadjuvant chemotherapy in advanced stage tubo-ovarian high-grade serous carcinoma. This prognostic biomarker has been included in ovarian cancer pathology reporting guidelines (International Collaboration on Cancer Reporting, College of American Pathologists) and in the upcoming European Society for Medical Oncology-European Society of Gynaecological Oncology (ESMO-ESGO) guidelines for ovarian cancer management. We present follow-up data on the CRS validation initiatives and suggest research with novel therapeutic agents incorporating this biomarker.MethodsThe cohort on whom CRS was originally developed was analyzed after an extended follow-up of an additional 36 months. The CRS histopathologic scoring system was applied to omental sections obtained at interval surgery from all 80 patients. Progression-free and overall survival were re-calculated.ResultsAfter a median follow-up of 4.3 years the CRS score predicted progression-free survival with an HR of 0.39 (95% CI 0.21 to 0.70), p = 0.002 adjusted for age, stage, and debulking status (median 1.08 vs 2.27 years for CRS1/2 vs CRS3). CRS was also predictive of overall survival with an HR of 0.17 (95% CI 0.07 to 0.44), p = 0.0002 adjusted for age, stage, and debulking status (median 2.55 vs 5.47 years for CRS1/2 vs CRS3).ConclusionCRS3 is a reproducible prognostic biomarker for improved progression-free and overall survival in stage 3C or 4 tubo-ovarian high-grade serous carcinoma after neoadjuvant chemotherapy. The score, obtained at interval debulking surgery, can help facilitate research and biomarker driven first-line treatment of patients with advanced ovarian cancer. |
| Databáze: | OpenAIRE |
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