Next-generation sequencing improves OS in ovarian cancer
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New data have linked next-generation sequencing with improved overall survival in ovarian cancer, according to a presenter at the virtual ASCO Annual Meeting.
“Ovarian cancer is the second most common gynecologic malignancy and the most common cause of gynecologic cancer mortality in the United States,” Tamar Safra, MD, of Tel Aviv Sourasky Medical Center’s oncology department and Tel Aviv University, and colleagues wrote in their abstract. “Homologous recombination deficiency, including the BRCA mutations, are found in 50% of ovarian cancer tumors. Next-generation sequencing provides understanding of the underlying molecular and genetic patterns to improve ovarian cancer treatment.”
Safra and colleagues assessed OS and progression-free survival by retrospectively examining information from patients with ovarian cancer treated at the Tel Aviv Sourasky Medical Center between 2002 and 2020. They compared data from 103 patients who completed next-generation sequencing testing in the form of comprehensive genomic profiling with data from 804 patients who did not undergo testing. Of those who had actionable mutations, 21 received matched targeted therapy.
The most common actionable mutation was BRCA, which was present in approximately 26% of the tested population vs. approximately 36% of the untested population. BRCA1 and BRCA2 made up approximately 19% and 9% of all observed mutations, respectively, according to Safra. Other common mutations included TP53, which appeared in approximately 78% of patients and CCNE1 in approximately 18% of patients.
Median PFS was similar between the tested and untested groups (17.23 and 17.43 months, respectively). However, median OS was significantly better in the tested group than the control group (73.36 vs. 68.5 months; P = .02).
Additionally, the researchers found loss of heterozygosity (LOH) was significantly prognostic, as patients with more than 16% LOH had longer OS than patients with less than 16% LOH. They also found that OS was longer in people with high LOH and BRCA mutations than in those with low LOH and no BRCA mutations, according to the abstract.
Furthermore, among patients treated by actionable mutations, the median duration of response was 4.7 months with prior line of therapy and 8.8 months after receiving matched therapy.
“So, we can conclude that next-generation sequencing testing does provide substantial OS benefit in ovarian cancer populations,” Safra said during a presentation of the data. “Comprehensive genomic profiling testing may provide both prognostic and predictive insight into the treatment of ovarian cancer population. BRCA and high LOH both are associated with improved response to PARP inhibitors and overall survival.”
Safra also noted that prospective studies of a larger cohort are warranted.
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Safra T, et al. Abstract 5553. Presented at: ASCO Annual Meeting; June 4-8, 2021 (virtual meeting).
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