The ability of T-cell–inflamed GEP (Ayers et al. J Clin Inv. 2017) to predict clinical outcome in ovarian cancer is not fully understood. A retrospective observational study was conducted to evaluate the prognostic value of GEP and its association with programmed death ligand 1 (PD-L1) expression in patients with advanced epithelial ovarian, primary peritoneal, or fallopian tube cancer (OvCa).
Patients diagnosed as FIGO stages II-IV OvCa from 2004 to 2012 at Aarhus University Hospital and Rigshospitalet, Copenhagen, Denmark, were included. Patients were considered platinum sensitive if treatment-free interval [TFI] was ≥6 months. PD-L1 was assayed using the 22C3 antibody, and positivity was defined as ≥ 1 stained tumor or immune cells per 100 tumor cells. T-cell–inflamed GEP score was defined as low (< –0.318), intermediate (–0.318 to < –0.162), or high (≥ –0.162). The log-rank test and Cox proportional hazards model were used for survival analyses, adjusting for age, stage, histology, residual tumor, surgery type, performance status, platinum sensitivity, and PD-L1 expression status.
Median age of the 376 patients was 63 years (range, 26-86); 9%, 70%, and 20% were FIGO stages II, III, and IV disease, respectively. Of these patients, 80% had type II histologic type, and 76% were platinum sensitive; 49% had a GEP score of low, 16% had intermediate, and 35% had high. Baseline characteristics between GEP groups were similar; PD-L1 and GEP scores were correlated (Spearman r, 0.71; Kendall tau r, 0.57). Median overall survival (OS) was 43 months (95% CI, 38-49) in all patients and was similar for patients with low GEP (41 months) and intermediate GEP (40 months), compared with patients with high GEP (52 months). There was no significant association between GEP status (intermediate/low vs high) and OS among all patients (adjusted hazard ratio, 1.00 [95% CI, 0.72-1.38]), by platinum sensitivity or by PD-L1 expression status.
GEP correlated with PD-L1 expression in patients with advanced OvCa, but OS was not significantly different between GEP categories.
Clinical trial identification
Legal entity responsible for the study
Merck & Co., Inc.
Merck & Co., Inc.
Medical writing and/or editorial assistance was provided by Matthew Grzywacz, PhD, of the ApotheCom pembrolizumab team (Yardley, PA, USA). This assistance was funded by Merck & Co., Inc., Kenilworth, NJ, USA.
P-T. Vo, W. Zhou: Employee and stockholder: Merck. L. Huang: Employee: Merck. M. Marton: Employee and stockholder: Merck; Stockholder of Biogen, CVS Health, Gilead Sciences, Intuitive Surgical, Johnson and Johnson, Pfizer and United Health Group. S.M. Keefe: Employment: Merck. M. Busch-Sørensen: Employment and stockholder: Merck. T. Steiniche: Research funding: Merck; Travel expenses: Merck. All other authors have declared no conflicts of interest.