Oncological outcomes of intraperitoneal chemotherapy in advanced ovarian cancer: BRCA mutation role.

Fecha de publicación: 01/04/2024 Fecha Ahead of Print: 09/03/2024

Autores de IIS La Fe

Pablo Padilla Iserte

Autor
Rosa Navarro Villanueva

Autor
César Díaz García

Autor
Juan Gilabert Estelles

Autor
Víctor Lago Leal

Autor
Santiago Domingo Del Pozo

Autor

Participantes ajenos a IIS La Fe

Iváñez M
Muruzabal JC
Díaz-Feijoo B
Iacoponi S
García-Pineda V
Utrilla-Layna J
Gil-Moreno A
Serra A
Martínez Canto C
Tejerizo Á
Cárdenas-Rebollo JM
SEGO Spain-GOG Group

Grupos

Medicina Reproductiva

Investigador Principal

José Morales Roselló

Abstract

INTRODUCTION: The knowledge of BRCA status offers a chance to evaluate the role of the intraperitoneal route in patients selected by biomolecular profiles after primary cytoreduction surgery in advanced ovarian cancer. MATERIALS AND METHODS: We performed a retrospective, multicenter study to assess oncological outcomes depending on adjuvant treatment (intraperitoneal [IP] vs intravenous [IV]) and BRCA status (BRCA1/2 mutated vs. BRCA wild type [WT]). The primary endpoint was to determine progression-free survival. The secondary objectives were overall survival and toxicity. RESULTS: A total of 288 women from eight centers were included: 177 in the IP arm and 111 in the IV arm, grouped into four arms according to BRCA1/2 status. Significantly better PFS was observed in BRCA1/2-mutated patients with IP chemotherapy (HR: 0.35; 95% CI, 0.16-0.75, p = 0.007), which was not present in BRCA1/2-mutated patients with IV chemotherapy (HR: 0.65; 95% CI, 0.37-1.12, p = 0.14). Significantly better OS was also observed in IP chemotherapy (HR: 0.17; 95% CI, 0.06-043, p < 0.0001), but was not present in IV chemotherapy in relation with BRCA mutation (HR: 0.52; 95% CI, 0.22-1.27, p = 0.15). For BRCA WT patients, worse survival was observed regardless of the adjuvant route used. The IP route was more toxic compared to the IV route, but toxicity was equivalent at the long-term follow-up. CONCLUSION: This retrospective study suggests that BRCA status can help to offer an individualized, systematic treatment after optimal primary surgery for advanced ovarian cancer, but is limited by the small sample size. Prospective trials are essential to confirm these results.

Datos de la publicación

ISSN/ISSNe:: 0748-7983, 1532-2157
Tipo:: Article
Páginas:: 108263-108263
DOI:: 10.1016/j.ejso.2024.108263
Factor de Impacto:: 1,016 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Padilla-Iserte P:: Department of Gynecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
Iváñez M:: Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
Muruzabal JC:: Department of Gynecologic Oncology, Hospital Universitario de Navarra, Spain
Navarro R:: Department of Gynecologic Oncology, MD Anderson Cancer Center Madrid, Spain
Díaz-Feijoo B:: Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
Iacoponi S:: Department of Obstetrics and Gynaecology, University Quirónsalud Madrid Hospital, Spain
García-Pineda V:: Department of Gynecologic Oncology, La Paz University Hospital, Madrid, Spain
Díaz C:: Department of Gynecology, Valencian Institute of Oncology (IVO), Spain
Utrilla-Layna J:: Department of Gynecological Oncology, Fundación Jiménez Diaz, Madrid, Spain
Gil-Moreno A:: Gynecologic Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Institut de Recerca Biomèdica en Ginecologia-VHIR, CIBERONC, Barcelona, Spain
Serra A:: Department of Obstetrics and Gynecology, Multidisciplinary Unit of Abdominal Pelvic Oncology Surgery (MUAPOS), University General Hospital of Castellón, Spain
Gilabert-Estellés J:: Department of Obstetrics and Gynecology, University General Hospital of Valencia Spain, Spain
Martínez Canto C:: Department of Gynecology and Obstetrics, University Hospital Son Llàtzer, Mallorca, Spain
Tejerizo Á:: Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Hospital Universitario 12 de Octubre, Madrid, Spain

Instituto de Investigación i+12, Universidad Complutense de Madrid, Spain
Lago V:: Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain
Cárdenas-Rebollo JM:: Department of Applied Mathematics and Statistics, CEU San Pablo University Madrid, Spain
Domingo S:: Department of Gynaecologic Oncology, La Fe University and Polytechnic Hospital, Valencia, Spain