TY - JOUR
T1 - Clinical analysis of pathologic complete responders in advanced-stage ovarian cancer
AU - LaFargue, Christopher J.
AU - Handley, Katelyn F.
AU - Fleming, Nicole D.
AU - Nick, Alpa M.
AU - Chelariu-Raicu, Anca
AU - Fellman, Bryan
AU - Castellano, Tara
AU - Ogasawara, Aiko
AU - Hom-Tedla, Marianne
AU - Blake, Erin A.
AU - da Costa, Alexandre A.B.A.
AU - Crim, Aleia K.
AU - Rauh-Hain, Alejandro
AU - Westin, Shannon N.
AU - Coleman, Robert L.
AU - Matsuo, Koji
AU - Baiocchi, Glauco
AU - Hasegawa, Kosei
AU - Moore, Kathleen
AU - Sood, Anil K.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: To determine the clinical characteristics of patients who attained pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) and to identify specific predictive or prognostic factors associated with pCR. Methods: Two distinct populations of patients who underwent NACT followed by interval tumor reductive surgery (TRS) were used in this retrospective study. The first contained 472 patients from a single institution. The second contained only pCR patients (67); those identified from population one, plus 44 obtained through collaborative institutions. Cox analysis and log-rank tests were performed to assess associations between clinical characteristics and pCR outcome, recurrence-free survival (RFS), and overall survival (OS). Results: The median RFS and OS in our pCR-only population was 24.2 and 80.8 months, respectively, with a median follow-up time of 32.4 months. In our single institution population, 23 patients attained pCR (4.9%) and had longer RFS compared to non-pCR patients with viable microscopic, optimal, or suboptimal residual disease (24.3 vs. 12.1 vs. 11.6 vs. 9.6 months, p = 0.025, 0.012, 0.008, respectively), and longer OS compared to those with optimal or suboptimal residual disease (54.5 vs. 29.4 vs. 25.7 months, p = 0.027, 0.007, respectively). Patients were more than three-fold likely to attain pCR if their CA125 value was normal at the time of surgery (OR 3.54, 95% CI: 1.14–11.05, p = 0.029). Conclusions: Women with pCR after NACT have significantly longer RFS compared to those with residual viable tumor at the time of interval tumor-reductive surgery, and CA125 is plausible biomarker for identifying these extreme responders preoperatively.
AB - Objective: To determine the clinical characteristics of patients who attained pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) and to identify specific predictive or prognostic factors associated with pCR. Methods: Two distinct populations of patients who underwent NACT followed by interval tumor reductive surgery (TRS) were used in this retrospective study. The first contained 472 patients from a single institution. The second contained only pCR patients (67); those identified from population one, plus 44 obtained through collaborative institutions. Cox analysis and log-rank tests were performed to assess associations between clinical characteristics and pCR outcome, recurrence-free survival (RFS), and overall survival (OS). Results: The median RFS and OS in our pCR-only population was 24.2 and 80.8 months, respectively, with a median follow-up time of 32.4 months. In our single institution population, 23 patients attained pCR (4.9%) and had longer RFS compared to non-pCR patients with viable microscopic, optimal, or suboptimal residual disease (24.3 vs. 12.1 vs. 11.6 vs. 9.6 months, p = 0.025, 0.012, 0.008, respectively), and longer OS compared to those with optimal or suboptimal residual disease (54.5 vs. 29.4 vs. 25.7 months, p = 0.027, 0.007, respectively). Patients were more than three-fold likely to attain pCR if their CA125 value was normal at the time of surgery (OR 3.54, 95% CI: 1.14–11.05, p = 0.029). Conclusions: Women with pCR after NACT have significantly longer RFS compared to those with residual viable tumor at the time of interval tumor-reductive surgery, and CA125 is plausible biomarker for identifying these extreme responders preoperatively.
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U2 - 10.1016/j.ygyno.2022.02.006
DO - 10.1016/j.ygyno.2022.02.006
M3 - Article
C2 - 35216808
AN - SCOPUS:85125124769
SN - 0090-8258
VL - 165
SP - 82
EP - 89
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -