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논문 기본 정보

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저자정보
Silvana Talisa Wijaya (Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore) David SP Tan (Cancer Science Institute of Singapore, National University of Singapore, Singapore) Natalie YL Ngoi (National University Cancer Institute, Singapore, Singapore) Jerold WZ Loh (Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore) Tuan Zea Tan (Cancer Science Institute of Singapore, National University of Singapore, Singapore) Diana Lim (Department of Pathology, National University Health System, Singapore) Irfan Sagir Khan (Department of Pathology, National University Health System, Singapore) Yee Liang Thian (Department of Diagnostic Imaging, National University Health System, Singapore) Alexa Lai (Department of Haematology-Oncology, National University Cancer Institute Singapore, Singapore) Bertrand WL Ang (Department of Diagnostic Imaging, National University Health System, Singapore) Pearl Tong (Division of Gynaecologic Oncology, Department of Obstetrics & Gynaecology, National University Hospital, Singapore)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.35 No.5
발행연도
2024.9
수록면
1 - 15 (15page)
DOI
https://doi.org/10.3802/jgo.2024.35.e69

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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.
#Immunotherapy #Bevacizumab #Ovarian Neoplasms #Adenocarcinoma #Clear Cell #Cytoreduction Surgical Procedures

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