Skip to main content
Journal cover image

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data.

Publication ,  Journal Article
Cohen, PA; Powell, A; Böhm, S; Gilks, CB; Stewart, CJR; Meniawy, TM; Bulsara, M; Avril, S; Brockbank, EC; Bosse, T; de Azevedo Focchi, GR ...
Published in: Gynecol Oncol
August 2019

OBJECTIVE: There is a need to develop and validate biomarkers for treatment response and survival in tubo-ovarian high-grade serous carcinoma (HGSC). The chemotherapy response score (CRS) stratifies patients into complete/near-complete (CRS3), partial (CRS2), and no/minimal (CRS1) response after neoadjuvant chemotherapy (NACT). Our aim was to review current evidence to determine whether the CRS is prognostic in women with tubo-ovarian HGSC treated with NACT. METHODS: We established an international collaboration to conduct a systematic review and meta-analysis, pooling individual patient data from 16 sites in 11 countries. Patients had stage IIIC/IV HGSC, 3-4 NACT cycles and >6-months follow-up. Random effects models were used to derive combined odds ratios in the pooled population to investigate associations between CRS and progression free and overall survival (PFS and OS). RESULTS: 877 patients were included from published and unpublished studies. Median PFS and OS were 15 months (IQR 5-65) and 28 months (IQR 7-92) respectively. CRS3 was seen in 249 patients (28%). The pooled hazard ratios (HR) for PFS and OS for CRS3 versus CRS1/CRS2 were 0·55 (95% CI, 0·45-0·66; P < 0·001) and 0·65 (95% CI 0·50-0·85, P = 0·002) respectively; no heterogeneity was identified (PFS: Q = 6·42, P = 0·698, I2 = 0·0%; OS: Q = 6·89, P = 0·648, I2 = 0·0%). CRS was significantly associated with PFS and OS in multivariate models adjusting for age and stage. Of 306 patients with known germline BRCA1/2 status, those with BRCA1/2 mutations (n = 80) were more likely to achieve CRS3 (P = 0·027). CONCLUSIONS: CRS3 was significantly associated with improved PFS and OS compared to CRS1/2. This validation of CRS in a real-world setting demonstrates it to be a robust and reproducible biomarker with potential to be incorporated into therapeutic decision-making and clinical trial design.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

August 2019

Volume

154

Issue

2

Start / End Page

441 / 448

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasms, Cystic, Mucinous, and Serous
  • Neoadjuvant Therapy
  • Humans
  • Female
  • Fallopian Tube Neoplasms
  • Disease-Free Survival
  • Carboplatin
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cohen, P. A., Powell, A., Böhm, S., Gilks, C. B., Stewart, C. J. R., Meniawy, T. M., … Singh, N. (2019). Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data. Gynecol Oncol, 154(2), 441–448. https://doi.org/10.1016/j.ygyno.2019.04.679
Cohen, Paul A., Aime Powell, Steffen Böhm, C Blake Gilks, Colin J. R. Stewart, Tarek M. Meniawy, Max Bulsara, et al. “Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data.Gynecol Oncol 154, no. 2 (August 2019): 441–48. https://doi.org/10.1016/j.ygyno.2019.04.679.
Cohen PA, Powell A, Böhm S, Gilks CB, Stewart CJR, Meniawy TM, et al. Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data. Gynecol Oncol. 2019 Aug;154(2):441–8.
Cohen, Paul A., et al. “Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data.Gynecol Oncol, vol. 154, no. 2, Aug. 2019, pp. 441–48. Pubmed, doi:10.1016/j.ygyno.2019.04.679.
Cohen PA, Powell A, Böhm S, Gilks CB, Stewart CJR, Meniawy TM, Bulsara M, Avril S, Brockbank EC, Bosse T, de Azevedo Focchi GR, Ganesan R, Glasspool RM, Howitt BE, Kim H-S, Lee J-Y, Le ND, Lockley M, Manchanda R, Mandalia T, McCluggage WG, McNeish I, Midha D, Srinivasan R, Tan YY, van der Griend R, Yunokawa M, Zannoni GF, HGSC CRS Collaborative Network (Supplementary 1), Singh N. Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data. Gynecol Oncol. 2019 Aug;154(2):441–448.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

August 2019

Volume

154

Issue

2

Start / End Page

441 / 448

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasms, Cystic, Mucinous, and Serous
  • Neoadjuvant Therapy
  • Humans
  • Female
  • Fallopian Tube Neoplasms
  • Disease-Free Survival
  • Carboplatin