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Comprehensive characterization of genomic features and clinical outcomes following targeted therapy and secondary cytoreductive surgery in OCCC: a single center experience.
Wijaya, Silvana Talisa; Ngoi, Natalie Yl; Loh, Jerold Wz; Tan, Tuan Zea; Lim, Diana; Khan, Irfan Sagir; Thian, Yee Liang; Lai, Alexa; Ang, Bertrand Wl; Tong, Pearl; Ng, Joseph; Low, Jeffrey Jh; Ilancheran, Arunachalam; Lim, Siew Eng; Lim, Yi Wan; Tan, David Sp.
Afiliação
  • Wijaya ST; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
  • Ngoi NY; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
  • Loh JW; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
  • Tan TZ; Cancer Science Institute of Singapore, National University of Singapore, Singapore.
  • Lim D; Genomics and Data Analytics Core (GeDaC), Cancer Science Institute of Singapore, National University of Singapore, Singapore.
  • Khan IS; Department of Pathology, National University Health System, Singapore.
  • Thian YL; Department of Pathology, National University Health System, Singapore.
  • Lai A; Department of Diagnostic Imaging, National University Health System, Singapore.
  • Ang BW; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
  • Tong P; Department of Diagnostic Imaging, National University Health System, Singapore.
  • Ng J; Division of Gynaecologic Oncology, Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
  • Low JJ; Division of Gynaecologic Oncology, Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
  • Ilancheran A; Division of Gynaecologic Oncology, Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
  • Lim SE; Division of Gynaecologic Oncology, Department of Obstetrics & Gynaecology, National University Hospital, Singapore.
  • Lim YW; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
  • Tan DS; Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore.
J Gynecol Oncol ; 2024 Mar 29.
Article em En | MEDLINE | ID: mdl-38606821
ABSTRACT

OBJECTIVE:

Ovarian clear cell carcinoma (OCCC) is associated with chemoresistance. Limited data exists regarding the efficacy of targeted therapies such as immune checkpoint inhibitors (ICI) and bevacizumab, and the role of secondary cytoreductive surgery (SCS).

METHODS:

We retrospectively analyzed genomic features and treatment outcomes of 172 OCCC patients treated at our institution from January 2000 to May 2022. Next-generation sequencing (NGS) was performed where sufficient archival tissue was available.

RESULTS:

64.0% of patients were diagnosed at an early stage, and 36.0% at an advanced stage. Patients with advanced/relapsed OCCC who received platinum-based chemotherapy plus bevacizumab followed by maintenance bevacizumab had a median first-line progression-free survival (PFS) of 12.2 months, compared with 9.3 months for chemotherapy alone (hazard ratio=0.69; 95% confidence interval [CI]=0.33, 1.45). In 27 patients who received an ICI, the overall response rate was 18.5% and median duration of response was 7.4 months (95% CI=6.5, 8.3). In 17 carefully selected patients with fewer than 3 sites of relapse, median PFS was 35 months (95% CI=0, 73.5) and median overall survival was 96.8 months (95% CI=44.6, 149.0) after SCS. NGS on 58 tumors revealed common mutations in ARID1A (48.3%), PIK3CA (46.6%), and KRAS (20.7%). Pathogenic alterations in PIK3CA, FGFR2, and NBN were associated with worse survival outcomes. Median tumor mutational burden was 3.78 (range, 0-16). All 26 patients with available loss of heterozygosity (LOH) scores had LOH <16%.

CONCLUSION:

Our study demonstrates encouraging outcomes with bevacizumab and ICI, and SCS in select relapsed OCCC patients. Prospective trials are warranted.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Gynecol Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Gynecol Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Singapura