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International Journal of Cancer
Article . 2019 . Peer-reviewed
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Genomic profiling of the residual disease of advanced high‐grade serous ovarian cancer after neoadjuvant chemotherapy

Authors: Yong J. Lee; Dachan Kim; Jung E. Shim; Su‐Jin Bae; Yu‐Jin Jung; Sora Kim; Hanna Lee; +5 Authors

Genomic profiling of the residual disease of advanced high‐grade serous ovarian cancer after neoadjuvant chemotherapy

Abstract

The goal of our study was to demonstrate the spectrum of genomic alterations present in the residual disease of patients with advanced high‐grade serous ovarian cancer (HGSOC) after neoadjuvant chemotherapy (NAC), including matched pretreatment biopsies. During the study period between 2006 and 2017, we collected pre‐NAC and post‐NAC tumor tissue samples from patients with advanced HGSOC. We performed combined next‐generation sequencing and immunohistochemistry to identify actionable targets and pathway activation in post‐NAC residual tumors. We also examined whether post‐NAC profiling of residual HGSOC identified targetable molecular lesions in the chemotherapy‐resistant component of tumors. Among 102 post‐NAC samples, 41 (40%) of patients had mutations in homologous recombination repair (HRR) genes (HRR deficiency). Patients with HRR mutations had higher tumor mutation burdens (p < 0.001) and higher alterations in the PI3K–AKT–mTOR pathway (p = 0.004) than patients without these HRR mutations. Nevertheless, we found no significant differences in progression‐free survival (p = 0.662) and overall survival (OS; p = 0.828) between the two groups. Most patients (91%) had alterations in at least one of the targetable pathways, and those patients with cell cycle (p = 0.004) and PI3K–AKT–mTOR signaling (p = 0.005) pathway alterations had poorer OS (Bonferroni‐corrected threshold = 0.0083, 0.05/6). We showed the genomic landscape of tumor cells remaining in advanced HGSOC after NAC. Once validated, these data can help inform biomarker‐driven adjuvant studies in targeting residual tumors to improve the outcomes of patients with advanced HGSOC after NAC.

Country
Korea (Republic of)
Related Organizations
Keywords

Neoplasm, Residual, Biopsy, Drug Resistance, TOR Serine-Threonine Kinases/metabolism, Ovarian Neoplasms/therapy, Phosphatidylinositol 3-Kinases, Signal Transduction/drug effects, Serous/therapy, Antineoplastic Combined Chemotherapy Protocols, Proto-Oncogene Proteins c-akt/metabolism, Ovarian Neoplasms, Cell Cycle, Cytoreduction Surgical Procedures, Genomics, Middle Aged, Progression-Free Survival, Neoadjuvant Therapy, Ovariectomy/methods, ovarian cancer, Residual, Disease Progression, Female, Phosphatidylinositol 3-Kinases/metabolism, genomic profiling, Ovarian Neoplasms/mortality, Ovary/pathology*, Adult, Antineoplastic Combined Chemotherapy Protocols/pharmacology*, Ovarian Neoplasms/genetics*, 570, Ovariectomy, Cystadenocarcinoma, 610, Ovary/drug effects, Mutation/drug effects, Humans, Cell Cycle/genetics, Serous/genetics*, Retrospective Studies, Aged, Neoplasm/genetics, Neoadjuvant Therapy/methods, Ovary, Survival Analysis, Cystadenocarcinoma, Serous, Serous/mortality, Drug Resistance, Neoplasm, high-grade serous carcinoma, Mutation, residual disease, Neoplasm, Signal Transduction/genetics, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Cytoreduction Surgical Procedures/methods

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    popularity
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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
16
Top 10%
Top 10%
Top 10%
Green
Related to Research communities
Cancer Research