Abstract
The purpose of this study was to investigate the predictors of the effect of olaparib on platinum-sensitive recurrent ovarian cancer with unknown germline BRCA mutations. We retrospectively examined 20 patients with platinum-sensitive ovarian cancer who were treated at the Nippon Medical School Chiba Hokusoh Hospital, Japan, from 2018 to 2020. We found that the median progression-free survival was 11.4 months (95% Confidence interval (CI): 3.8–Not Available (NA)) in the group with NLPN score [recurrent neutrophil-lymphocyte ratio (rNLR) × number of previous regimens] >7.51, and median progression-free survival was not reached in the group with NLPN score <7.51 (95% CI: 21.8–NA) (p = 0.0185). There was a clear correlation between the degree of dose reduction of olaparib and recurrence (p = 0.00249). Our results show that NLPN scores lower than 7.51 are associated with a favorable outcome of olaparib treatment for platinum-sensitive recurrent ovarian cancer. In cases with a high rNLR, it may be necessary to start olaparib treatment as early as possible to obtain low NLPN scores. Our results imply that the effectiveness of olaparib can be determined after recurrence and before platinum treatment begins. As newer drugs for ovarian cancer are developed, the measurement of biomarker levels at the start of treatment for recurrent ovarian cancer, as shown in our study, may provide strong support for cancer treatment protocols.
Highlights
Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer-related deaths in women [1]
The purpose of this study was to explore the predictors of the effects of olaparib on platinum-sensitive recurrent ovarian cancer by analyzing data, such as neutrophil-to-lymphocyte ratio (NLR), systemic inflammation index (SII), blood inflammatory response, cancer antigen-125 (CA125) levels, and the number of chemotherapy rounds that the patients have undergone
Regarding bloodwork and olaparib effectiveness (Table 2), we investigated the relationship of neutrophil to lymphocyte counts (NRL)
Summary
Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer-related deaths in women [1]. Most patients are already at an advanced clinical stage of EOC at the time of diagnosis as the initial symptoms of EOC are unclear. The EOC survival rate is relatively short. EOCs are sensitive to chemotherapy and respond well to platinum/taxanes in the early stages of treatment, but the 5-year recurrence rate remains at 60% to 80%. Tumor development and progression can elicit an adaptive immune response, and antitumor immunity has been shown to be significantly correlated with patient prognosis. EOC is not a single entity, and various histological subtypes can develop from the ovarian epithelium, including low-grade serous, endometrial, clear cell, and mucinous ovarian cancers [2]. High-grade serous ovarian cancer (HGSOC) is the most common
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