Abstract 2235
Background
OCCC is a rare entity linked to good prognosis at early stages but chemoresistance and poor survival in advanced setting. Molecular heterogeneity is common in OCCC, with PI3K/mTOR pathway alterations as most common drivers.
Methods
Consecutive series of 75 patients (pts) with OCCC treated in VHH/VHIO from 2000 to 2016. Objective: to study outcomes with standard therapy (progression-free survival [PFS], overall survival [OS]) and treatment selection in a chemotherapy (ChT) resistant setting based on molecular profiling performed in house (targeted NGS panel).
Results
Median age was 55 years (y), FIGO (2014) stage I 51%, II 11%, III 33%, IV 5%. Primary surgery was performed in 92% achieving optimal cytoreduction in 86%. All pts received first-line of platinum (Pt)-based ChT. With a median follow-up of 9.5 y, 50.6% pts relapsed (I 34.2%, II 62.5%, III 68%, IV 50%), median OS was 11.2 y (CI95%: 6-NR). Factors significantly associated with relapse and death in univariate Cox models were ECOG performance status and stage at diagnosis (p < 0.001). At 1st and 2nd relapse, 58 and 50% remained Pt-sensitive, respectively. Median PFS with therapies after 1st relapse in a Pt-sensitive setting (91% Pt combos) was 12.6 months (m) (CI95% 9.5-25.4) and in Pt-resistant setting (69% non-platinum ChT) 3 m (2.5-NA). In total, 18 pts (24%) had genomic profiling (7 PIK3CA mut, 1 BRCA1 mut, 1 MSH6 mut), and 16 pts (21%) received experimental agents after 1st relapse (8 antiangiogenic, 4 targeted or immunotherapy unmatched, 4 targeted matched [3 PI3K inh and 1 PARP inh]). Median PFS was 4.8, 5.6 and 9.6 m respectively. When compared to non-Pt ChT in a Pt-resistant setting increased PFS was found with matched targeted agents (HR = 0.26, CI95% 0.1-1).
Conclusions
As reported in the literature, in our cohort, OCCC are more frequent diagnosed at early stages having a better prognosis. In the relapse setting Pt sensibility and Pt-based ChT imply better outcomes. However, in the Pt-resistant setting targeted therapies result in better PFS compared to ChT. Molecular profiling allows to select matched agents which may improve outcomes in this poor prognosis population. Further research in molecular characterization and matched targeted therapy is an unmet need.
Clinical trial identification
Legal entity responsible for the study
Vall d'Hebron Institute of Oncology (VHIO).
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5877 - TCR beta chain convergence defines the tumor infiltrating T cell repertoire of melanoma and non-small cell lung carcinoma.
Presenter: Timothy Looney
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3212 - PI3K inhibition and modulation of immune and tumor microenvironment markers by copanlisib in patients with non-Hodgkin's lymphoma or advanced solid tumors
Presenter: Ahmad Awada
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
3574 - Pan-squamous genomic profiling stratified by anatomic tumor site and viral association
Presenter: Meagan Montesion
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4113 - Toward the Standardization of Bioinformatics Methods for the Accurate Assessment of Tumor Mutational Burden (TMB)
Presenter: Han Chang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4468 - Prediction of primary resistance to anti-PD1 therapy (APD1) in 2nd line NSCLC
Presenter: Egbert Smit
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
4570 - Immunomodulatory germline variation impacts the development of multiple primary melanoma (MPM).
Presenter: Robert Ferguson
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
1169 - Leukocyte telomere length and recurrence risk after EGFR-TKIs therapy in patients with advanced lung adenocarcinoma
Presenter: Ming Yang
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
1707 - Gene embedding: a novel machine learning approach to identify gene candidates related to immunotherapy responsiveness
Presenter: Chi Tung Choy
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
2123 - Common and rare DPYD variants are predictive for 5FU/capecitabine (5FU) toxicity: The MRC COIN and COIN-B trials
Presenter: Ayman Madi
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract
5671 - The landscape of NTRK fusions in Chinese solid tumor patients
Presenter: Qi Ling
Session: Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research
Resources:
Abstract