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@article{Cohen:2019:10.1016/j.ygyno.2019.04.679,
author = {Cohen, PA and Powell, A and Böhm, S and Gilks, CB and Stewart, CJR and Meniawy, TM and Bulsara, M and Avril, S and Brockbank, EC and Bosse, T and de, Azevedo Focchi GR and Ganesan, R and Glasspool, RM and Howitt, BE and Kim, H-S and Lee, J-Y and Le, ND and Lockley, M and Manchanda, R and Mandalia, T and McCluggage, WG and McNeish, I and Midha, D and Srinivasan, R and Tan, YY and van, der Griend R and Yunokawa, M and Zannoni, GF and HGSC, CRS Collaborative Network Supplementary 1 and Singh, N},
doi = {10.1016/j.ygyno.2019.04.679},
journal = {Gynecologic Oncology},
pages = {441--448},
title = {Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: a systematic review and meta-analysis of individual patient data},
url = {http://dx.doi.org/10.1016/j.ygyno.2019.04.679},
volume = {154},
year = {2019}
}

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TY  - JOUR
AB  - ObjectiveThere 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.MethodsWe 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between CRS and progression free and overall survival (PFS and OS).Results877 patients were included from published and unpublished studies. Median PFS and OS were 15months (IQR 5–65) and 28months (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).ConclusionsCRS3 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
AU  - Cohen,PA
AU  - Powell,A
AU  - Böhm,S
AU  - Gilks,CB
AU  - Stewart,CJR
AU  - Meniawy,TM
AU  - Bulsara,M
AU  - Avril,S
AU  - Brockbank,EC
AU  - Bosse,T
AU  - de,Azevedo Focchi GR
AU  - Ganesan,R
AU  - Glasspool,RM
AU  - Howitt,BE
AU  - Kim,H-S
AU  - Lee,J-Y
AU  - Le,ND
AU  - Lockley,M
AU  - Manchanda,R
AU  - Mandalia,T
AU  - McCluggage,WG
AU  - McNeish,I
AU  - Midha,D
AU  - Srinivasan,R
AU  - Tan,YY
AU  - van,der Griend R
AU  - Yunokawa,M
AU  - Zannoni,GF
AU  - HGSC,CRS Collaborative Network Supplementary 1
AU  - Singh,N
DO  - 10.1016/j.ygyno.2019.04.679
EP  - 448
PY  - 2019///
SN  - 0090-8258
SP  - 441
TI  - Pathological chemotherapy response score is prognostic in tubo-ovarian high-grade serous carcinoma: a systematic review and meta-analysis of individual patient data
T2  - Gynecologic Oncology
UR  - http://dx.doi.org/10.1016/j.ygyno.2019.04.679
UR  - http://hdl.handle.net/10044/1/70311
VL  - 154
ER  -

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