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Exploratory biomarker analysis in the phase III L-MOCA study of olaparib maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer

تحليل المؤشرات الحيوية الاستكشافية في المرحلة الثالثة من دراسة L - MOCA لعلاج صيانة olaparib في المرضى الذين يعانون من سرطان المبيض الانتكاسي الحساس للبلاتين
Authors: Huayi Li; Zhufeng Peng; Jun Zhu; Weidong Zhang; Yi Huang; Ruifang An; Hong Zheng; +26 Authors

Exploratory biomarker analysis in the phase III L-MOCA study of olaparib maintenance therapy in patients with platinum-sensitive relapsed ovarian cancer

Abstract

Abstract Background The prospective phase III multi-centre L-MOCA trial (NCT03534453) has demonstrated the encouraging efficacy and manageable safety profile of olaparib maintenance therapy in the Asian (mainly Chinese) patients with platinum-sensitive relapsed ovarian cancer (PSROC). In this study, we report the preplanned exploratory biomarker analysis of the L-MOCA trial, which investigated the effects of homologous recombination deficiency (HRD) and programmed cell death ligand 1 (PD-L1) expression on olaparib efficacy. Methods HRD status was determined using the ACTHRD assay, an enrichment-based targeted next-generation sequencing assay. PD-L1 expression was assessed by SP263 immunohistochemistry assay. PD-L1 expression positivity was defined by the PD-L1 expression on ≥ 1% of immune cells. Kaplan–Meier method was utilised to analyse progression-free survival (PFS). Results This exploratory biomarker analysis included 225 patients and tested HRD status [N = 190; positive, N = 125 (65.8%)], PD-L1 expression [N = 196; positive, N = 56 (28.6%)], and BRCA1/2 mutation status (N = 219). The HRD-positive patients displayed greater median PFS than the HRD-negative patients [17.9 months (95% CI: 14.5–22.1) versus 9.2 months (95% CI: 7.5–13.8)]. PD-L1 was predominantly expressed on immune cells. Positive PD-L1 expression on immune cells was associated with shortened median PFS in the patients with germline BRCA1/2 mutations [14.5 months (95% CI: 7.4–18.2) versus 22.2 months (95% CI: 18.3–NA)]. Conversely, positive PD-L1 expression on immune cells was associated with prolonged median PFS in the patients with wild-type BRCA1/2 [20.9 months (95% CI: 13.9–NA) versus 8.3 months (95% CI: 6.7–13.8)]. Conclusions HRD remained an effective biomarker for enhanced olaparib efficacy in the Asian patients with PSROC. Positive PD-L1 expression was associated with decreased olaparib efficacy in the patients with germline BRCA1/2 mutations but associated with improved olaparib efficacy in the patients with wild-type BRCA1/2. Trial registration NCT03534453. Registered at May 23, 2018.

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Keywords

Nanoelectronics and Transistors, PD-L1 expression, Biochemistry, Gene, Piperazines, B7-H1 Antigen, Engineering, Olaparib, Poly(ADP-ribose) Polymerase Inhibition in Cancer Therapy, Prospective Studies, Homologous Recombination, PARP inhibitors, Internal medicine, Cancer, Ovarian Neoplasms, BRCA1 Protein, R, Progression-free survival, Platinum-Sensitive Ovarian Cancer, Middle Aged, Immunohistochemistry, Chemistry, Oncology, Genomic Studies and Treatment of Ovarian Carcinoma, Physical Sciences, Medicine, Female, Immunotherapy, Polymerase, Research Article, Adult, Immunology, 610, Antineoplastic Agents, R Medicine, Maintenance Chemotherapy, BRCA1/2, Ovarian cancer, Health Sciences, Biomarkers, Tumor, FOS: Electrical engineering, electronic engineering, information engineering, Humans, Chemotherapy, Electrical and Electronic Engineering, Aged, BRCA2 Protein, FOS: Clinical medicine, Biomarker, Platinum-sensitive relapsed ovarian cancer, Immune system, Reproductive Medicine, Phthalazines, Poly ADP ribose polymerase, Neoplasm Recurrence, Local, Homologous recombination deficiency

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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!
5
Top 10%
Average
Top 10%
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gold