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

The HGSC CRS Collaborative Network (Supplementary 1); Investigators

doi:10.1016/j.ygyno.2019.04.679

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

The HGSC CRS Collaborative Network (Supplementary 1)
, Investigators

St John of God Subiaco Hospital
University of Western Australia
University of Notre Dame Australia
Barts Health NHS Trust
Vancouver General Hospital
King Edward Memorial Hospital for Women
Sir Charles Gairdner Hospital
Case Western Reserve University
Technical University of Munich
Leiden University
Universidade Federal de São Paulo
Birmingham Women's and Children's NHS Foundation Trust
University of Glasgow
Stanford University
Yonsei University
Provincial Health Services Authority
Queen Mary University of London
University College London Hospitals NHS Foundation Trust
Royal Devon & Exeter NHS Foundation Trust
Belfast Health and Social Care Trust
Imperial College London
Tata Medical Center
Postgraduate Institute of Medical Education and Research
Beatson Oncology Centre
Canterbury District Health Board
National Cancer Center Japan
Catholic University of the Sacred Heart
St John of God Subiaco Hospital
University of Southern Denmark
IRCCS
Northern Ireland Cancer Centre
Department of Gynaecological Oncology

Research output: Contribution to journal › Review article › peer-review

102 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	441-448
Number of pages	8
Journal	Gynecologic Oncology
Volume	154
Issue number	2
DOIs	https://doi.org/10.1016/j.ygyno.2019.04.679
State	Published - Aug 2019
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Chemotherapy response score
High-grade serous tubo-ovarian cancer
Neoadjuvant chemotherapy
Prognosis

Access to Document

10.1016/j.ygyno.2019.04.679

Cite this

@article{94d677b2fafd46e4a6f31be117d2b887,

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

abstract = "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.",

keywords = "Chemotherapy response score, High-grade serous tubo-ovarian cancer, Neoadjuvant chemotherapy, Prognosis",

author = "\{The HGSC CRS Collaborative Network (Supplementary 1)\} and Investigators and Cohen, \{Paul A.\} and Aime Powell and Steffen B{\"o}hm and Gilks, \{C. Blake\} and Stewart, \{Colin J.R.\} and Meniawy, \{Tarek M.\} and Max Bulsara and Stefanie Avril and Brockbank, \{Eleanor C.\} and Tjalling Bosse and \{de Azevedo Focchi\}, \{Gustavo Rubino\} and Raji Ganesan and Glasspool, \{Rosalind M.\} and Howitt, \{Brooke E.\} and Kim, \{Hyun Soo\} and Lee, \{Jung Yun\} and Le, \{N. D.\} and Michelle Lockley and Ranjit Manchanda and Trupti Mandalia and McCluggage, \{W. Glenn\} and Iain McNeish and D. Midha and Radhika Srinivasan and Tan, \{Yun Yi\} and \{van der Griend\}, Rachael and Mayu Yunokawa and Zannoni, \{Gian F.\} and Simi Aggarwal and Holger Bronger and Brown, \{Elizabeth B.\} and Martin Buck and Bukhari, \{Syed A.\} and Edwina Coghlan and Nichola Cope and \{de Almeida\}, \{Michelle Samora\} and \{De Kroon\}, \{Cornelius D.\} and Andrew Dean and Devlin, \{Michael John\} and Ditzel, \{Helena M.\} and E. Drecoll and Anna Fagotti and Asma Faruqi and L. Feeney and Kavita Gupta and Ian Harley and Frediano Inzani and Jeyarajah, \{Arjun R.\} and Koay, \{M. H.Eleanor\} and Kroep, \{Judith R.\}",

note = "Publisher Copyright: {\textcopyright} 2019 The Authors",

year = "2019",

month = aug,

doi = "10.1016/j.ygyno.2019.04.679",

language = "English",

volume = "154",

pages = "441--448",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Academic Press Inc.",

number = "2",

}

Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data. / The HGSC CRS Collaborative Network (Supplementary 1); Investigators.
In: Gynecologic Oncology, Vol. 154, No. 2, 08.2019, p. 441-448.

Research output: Contribution to journal › Review article › peer-review

TY - JOUR

T1 - Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma

T2 - A systematic review and meta-analysis of individual patient data

AU - The HGSC CRS Collaborative Network (Supplementary 1)

AU - Investigators

AU - Cohen, Paul A.

AU - Powell, Aime

AU - Böhm, Steffen

AU - Gilks, C. Blake

AU - Stewart, Colin J.R.

AU - Meniawy, Tarek M.

AU - Bulsara, Max

AU - Avril, Stefanie

AU - Brockbank, Eleanor C.

AU - Bosse, Tjalling

AU - de Azevedo Focchi, Gustavo Rubino

AU - Ganesan, Raji

AU - Glasspool, Rosalind M.

AU - Howitt, Brooke E.

AU - Kim, Hyun Soo

AU - Lee, Jung Yun

AU - Le, N. D.

AU - Lockley, Michelle

AU - Manchanda, Ranjit

AU - Mandalia, Trupti

AU - McCluggage, W. Glenn

AU - McNeish, Iain

AU - Midha, D.

AU - Srinivasan, Radhika

AU - Tan, Yun Yi

AU - van der Griend, Rachael

AU - Yunokawa, Mayu

AU - Zannoni, Gian F.

AU - Aggarwal, Simi

AU - Bronger, Holger

AU - Brown, Elizabeth B.

AU - Buck, Martin

AU - Bukhari, Syed A.

AU - Coghlan, Edwina

AU - Cope, Nichola

AU - de Almeida, Michelle Samora

AU - De Kroon, Cornelius D.

AU - Dean, Andrew

AU - Devlin, Michael John

AU - Ditzel, Helena M.

AU - Drecoll, E.

AU - Fagotti, Anna

AU - Faruqi, Asma

AU - Feeney, L.

AU - Gupta, Kavita

AU - Harley, Ian

AU - Inzani, Frediano

AU - Jeyarajah, Arjun R.

AU - Koay, M. H.Eleanor

AU - Kroep, Judith R.

PY - 2019/8

Y1 - 2019/8

N2 - 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.

AB - 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.

KW - Chemotherapy response score

KW - High-grade serous tubo-ovarian cancer

KW - Neoadjuvant chemotherapy

KW - Prognosis

UR - https://www.scopus.com/pages/publications/85065775204

U2 - 10.1016/j.ygyno.2019.04.679

DO - 10.1016/j.ygyno.2019.04.679

M3 - Review article

C2 - 31118141

AN - SCOPUS:85065775204

SN - 0090-8258

VL - 154

SP - 441

EP - 448

JO - Gynecologic Oncology

JF - Gynecologic Oncology

IS - 2

ER -

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

Abstract

UN SDGs

Keywords

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