Barbara Stanley1, Robert L Hollis2, Hugo Nunes3, Jonathan D Towler4, Xiangfei Yan4, Tzyvia Rye2, Carol Dawson2, Melanie J Mackean4, Fiona Nussey4, Michael Churchman2, C Simon Herrington2, Charlie Gourley5. 1. Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK. 2. Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. 3. Instituto Português de Oncologia de Lisboa Francisco Gentil, Portugal. 4. Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK. 5. Nicola Murray Centre for Ovarian Cancer Research, Cancer Research UK Edinburgh Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK; Edinburgh Cancer Centre, Western General Hospital, Edinburgh, UK. Electronic address: charlie.gourley@ed.ac.uk.
Abstract
OBJECTIVES: The role of endocrine therapy (ET) in high grade serous ovarian carcinoma (HGSOC) is poorly defined due to the lack of phase III data and significant heterogeneity of clinical trials performed. In this study, we sought to identify predictive factors of endocrine sensitivity in HGSOC. METHODS: HGSOC patients who received at least four weeks of ET for relapsed disease following one line of chemotherapy at the Edinburgh Cancer Centre were identified. Exclusion criteria were use of endocrine therapy as maintenance therapy or of unknown duration. Duration of therapy and best CA125 response as per modified GCIG criteria were recorded. Oestrogen receptor (ER) histoscore, treatment free interval, prior lines of chemotherapy, and type of ET were evaluated as predictive factors. RESULTS: Of 431 patients identified, 269 were eligible (77.0% letrozole, 18.6% tamoxifen, 2.2% megesterol acetate, 2.2% other). The median duration of therapy was 126 days (range 28-1427 days). 32.7% remained on ET for ≥180 days and 14.1% for ≥365 days. The CA125 response and clinical benefit rates (response or stable disease) were 8.1% and 40.1% respectively. ER histoscore >200 (P = 0.0016) and a treatment free interval of ≥180 days (P < 0.0001) were independent predictive factors upon multivariable analysis. CONCLUSIONS: ET should be considered as a viable strategy to defer subsequent chemotherapy for relapsed HGSOC. Patients with an ER histoscore >200 and a treatment free interval of ≥180 days are most likely to derive benefit.
OBJECTIVES: The role of endocrine therapy (ET) in high grade serous ovarian carcinoma (HGSOC) is poorly defined due to the lack of phase III data and significant heterogeneity of clinical trials performed. In this study, we sought to identify predictive factors of endocrine sensitivity in HGSOC. METHODS: HGSOC patients who received at least four weeks of ET for relapsed disease following one line of chemotherapy at the Edinburgh Cancer Centre were identified. Exclusion criteria were use of endocrine therapy as maintenance therapy or of unknown duration. Duration of therapy and best CA125 response as per modified GCIG criteria were recorded. Oestrogen receptor (ER) histoscore, treatment free interval, prior lines of chemotherapy, and type of ET were evaluated as predictive factors. RESULTS: Of 431 patients identified, 269 were eligible (77.0% letrozole, 18.6% tamoxifen, 2.2% megesterol acetate, 2.2% other). The median duration of therapy was 126 days (range 28-1427 days). 32.7% remained on ET for ≥180 days and 14.1% for ≥365 days. The CA125 response and clinical benefit rates (response or stable disease) were 8.1% and 40.1% respectively. ER histoscore >200 (P = 0.0016) and a treatment free interval of ≥180 days (P < 0.0001) were independent predictive factors upon multivariable analysis. CONCLUSIONS: ET should be considered as a viable strategy to defer subsequent chemotherapy for relapsed HGSOC. Patients with an ER histoscore >200 and a treatment free interval of ≥180 days are most likely to derive benefit.
Authors: Ye Han; Yongkun Wei; Jun Yao; Yu-Yi Chu; Chia-Wei Li; Jennifer L Hsu; Lei Nie; Mien-Chie Hung Journal: Am J Cancer Res Date: 2020-04-01 Impact factor: 6.166
Authors: Robert L Hollis; Barbara Stanley; Yasushi Iida; John Thomson; Michael Churchman; Tzyvia Rye; Melanie Mackean; Fiona Nussey; Charlie Gourley; C Simon Herrington Journal: Gynecol Oncol Date: 2019-09-05 Impact factor: 5.482
Authors: Charlie Gourley; C Simon Herrington; Robert L Hollis; Barbara Stanley; John P Thomson; Michael Churchman; Ian Croy; Tzyvia Rye; Clare Bartos; Fiona Nussey; Melanie Mackean; Alison M Meynert; Colin A Semple Journal: NPJ Precis Oncol Date: 2021-06-02