dc.contributor.author | Cohen, PA | en_US |
dc.contributor.author | Powell, A | en_US |
dc.contributor.author | Böhm, S | en_US |
dc.contributor.author | Gilks, CB | en_US |
dc.contributor.author | Stewart, CJR | en_US |
dc.contributor.author | Meniawy, TM | en_US |
dc.contributor.author | Bulsara, M | en_US |
dc.contributor.author | Avril, S | en_US |
dc.contributor.author | Brockbank, EC | en_US |
dc.contributor.author | Bosse, T | en_US |
dc.contributor.author | de Azevedo Focchi, GR | en_US |
dc.contributor.author | Ganesan, R | en_US |
dc.contributor.author | Glasspool, RM | en_US |
dc.contributor.author | Howitt, BE | en_US |
dc.contributor.author | Kim, H-S | en_US |
dc.contributor.author | Lee, J-Y | en_US |
dc.contributor.author | Le, ND | en_US |
dc.contributor.author | Lockley, M | en_US |
dc.contributor.author | Manchanda, R | en_US |
dc.contributor.author | Mandalia, T | en_US |
dc.contributor.author | McCluggage, WG | en_US |
dc.contributor.author | McNeish, I | en_US |
dc.contributor.author | Midha, D | en_US |
dc.contributor.author | Srinivasan, R | en_US |
dc.contributor.author | Tan, YY | en_US |
dc.contributor.author | van der Griend, R | en_US |
dc.contributor.author | Yunokawa, M | en_US |
dc.contributor.author | Zannoni, GF | en_US |
dc.contributor.author | HGSC CRS Collaborative Network (Supplementary 1) | en_US |
dc.contributor.author | Singh, N | en_US |
dc.date.accessioned | 2019-07-22T12:31:40Z | |
dc.date.available | 2019-04-25 | en_US |
dc.date.issued | 2019-08 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/58607 | |
dc.description.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. | en_US |
dc.format.extent | 441 - 448 | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Gynecol Oncol | en_US |
dc.rights | © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject | Chemotherapy response score | en_US |
dc.subject | High-grade serous tubo-ovarian cancer | en_US |
dc.subject | Neoadjuvant chemotherapy | en_US |
dc.subject | Prognosis | en_US |
dc.subject | Antineoplastic Agents | en_US |
dc.subject | Antineoplastic Combined Chemotherapy Protocols | en_US |
dc.subject | Biomarkers, Tumor | en_US |
dc.subject | Carboplatin | en_US |
dc.subject | Disease-Free Survival | en_US |
dc.subject | Fallopian Tube Neoplasms | en_US |
dc.subject | Female | en_US |
dc.subject | Humans | en_US |
dc.subject | Neoadjuvant Therapy | en_US |
dc.subject | Neoplasms, Cystic, Mucinous, and Serous | en_US |
dc.subject | Ovarian Neoplasms | en_US |
dc.subject | Treatment Outcome | en_US |
dc.title | Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: A systematic review and meta-analysis of individual patient data. | en_US |
dc.type | Article | |
dc.rights.holder | (c) 2019 The Authors. | |
dc.identifier.doi | 10.1016/j.ygyno.2019.04.679 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/31118141 | en_US |
pubs.issue | 2 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 154 | en_US |
dcterms.dateAccepted | 2019-04-24 | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | New treatments for chemotherapy resistant high grader serous ovarian cancer::CRUK | en_US |
qmul.funder | New treatments for chemotherapy resistant high grader serous ovarian cancer::CRUK | en_US |