Tumor cure probability during alpha-RIT of ovarian cancer with different radiation sensitivity.

PURPOSE: To calculate the tumor cure probability (TCP) and metastatic cure probability (MCP) during alpha-radioimmunotherapy (alpha-RIT) of small ovarian cancer tumors with cells of different radiation sensitivity. MATERIALS AND METHODS: An in-house-developed biokinetic model and a Monte-Carlo program were used to calculate the cumulative activity on tumor cell surfaces and the specific energy to tumor cell nuclei, respectively. An in-house-developed computational model was used to calculate the TCP and MCP as a function of assumed radiation sensitivities, expressed as D(37), of the tumor cells. The calculations were performed using various assumptions regarding the activity distribution in measured tumors and used the alpha-particle energies emitted from astatine-211 ((211)At). Regarding the calculations of the cumulative activity on each cell surface, the number of antigenic sites expressed by NIH:OVCAR-3 cells for the mAb MX35 F(ab')2 was used. To illustrate the tumor growth at the peritoneum in nude mice, scanning electron microscopy images were used. RESULTS: In the case of a maximum diffusion depth of 30 mum for the activity in the tumors, the TCP was high for D(37) values not exceeding approximately 4.3, approximately 2.9, approximately 1.8, and approximately 0.8 Gy for 200, 100, 50, and 25 kBq (211)At-MX35 F(ab')2 four weeks after cell inoculation, respectively. In order to achieve complete remission of the metastatic disease in mice (i.e. MCP=1), the D(37) value should not exceed approximately 2.2, approximately 1.3, approximately 0.6, and approximately 0.3 Gy when injecting 200, 100, 50, or 25 kBq, respectively, assuming a maximum diffusion depth of 30 mum for the activity in the tumors. CONCLUSION: The radiation sensitivity, expressed as D(37), of tumor cells subjected to alpha-RIT could be decisive for therapeutic outcome, expressed as TCP or MCP, when treating small tumors of ovarian cancer.

High-resolution genomic profiling of carboplatin resistance in early-stage epithelial ovarian carcinoma.

Chemotherapy resistance remains a major obstacle to successful treatment of ovarian cancer patients. Therefore, increased knowledge of underlying mechanisms and identification of predictive factors are of great importance. Standard treatment for ovarian carcinoma is surgery followed by platinum-based chemotherapy. In this study, we aimed to search for genes or genomic regions involved in platinum resistance in ovarian carcinoma. Array-based comparative genomic hybridization (CGH) was used to identify genetic alterations in 32 early-stage epithelial ovarian carcinomas homogeneously treated with single-agent carboplatin. The arrays contain 33,370 bacterial artificial chromosome (BAC) clones and form a contiguous and tiling coverage of the human genome with an average resolution of approximately 100 kb. We found certain genetic changes associated with carboplatin response. Gains in 1q25.1-q41 were significantly more frequent in carboplatin-resistant tumours. In this region, we further detected two smallest regions of overlap (SRO) at 1q25.2 and 1q32.2 (approximately 690 and approximately 830 kb in size, respectively). Interestingly, we found some regions that were lost exclusively in the sensitive tumours 17q24.1, Xq21.33-q22.1, and 6 regions in 15q. We also detected genetic differences with regard to histologic subtype. Gain in 8q was found highly associated with serous and clear cell subtypes, and an SRO was identified at 8q24.22-q24.23. The genomic regions found altered in this study confirm some of our previous metaphase CGH results. The alteration found in chromosome arm 1q was verified and specified, and is therefore of great interest as a candidate for predictive markers. Identifying predictive markers of chemosensitive and chemoresistant disease would greatly help in the choice of chemotherapy in the clinic, and thus improve treatment of women with ovarian cancer.

Chromosomal alterations in 98 endometrioid adenocarcinomas analyzed with comparative genomic hybridization.

The aim of the present study was to investigate chromosomal alterations in a large set of homogeneous tumors, 98 endometrioid adenocarcinomas. We also wanted to evaluate differences in chromosomal alterations in the different groups of tumors in relation to stage, survival and invasive or metastatic properties of the tumors. Comparative genomic hybridization (CGH) was used to detect chromosomal alterations in tissue samples from 98 endometrioid adenocarcinomas. All chromosomes were involved in DNA copy number variations at least once in the tumor material, but certain changes were recurrent and rather specific. Among the specific changes, it was possible to identify 39 chromosomal regions displaying frequent DNA copy number alterations. The most frequent alteration was detected at 1q25-->q42, in which gains were found in 30 cases (30%). Gains at 19pter-->p13.1 were detected in 26 tumors (26%) and at 19q13.1-->q13.3 in 19 tumors (19%). Increased copy numbers were also detected at 8q (8q21-->q22 and 8q22-->qter), at a relatively high rate, in 17 cases (17%). Furthermore, gains at 10q21-->q23 and 10p were found in 14 (14%) and 13 cases (13%), respectively. The most common losses were found in the three regions 4q22-->qter, 16q21-->qter and 18q21-->qter, all of which were detected in eight of the 98 tumors (8%). We also detected differences between the tumors from deceased patients and from survivors. Gain at 1q25-->q42 was more commonly detected in the tumors from patients who died of cancer. We noted that the regions most affected differed in the different surgical stages (I-IV). The results of the CGH analysis identify specific chromosomal regions affected by copy number changes, appropriate objects for further genetic studies.