Immune-Hot tumor features associated with recurrence in early-stage ovarian clear cell carcinoma.

Abstract

Ovarian clear cell carcinoma (OCCC) is a distinct histotype of ovarian cancer, which usually presages a worse prognosis upon recurrence. Identifying patients at risk for relapse is an unmet need to improve outcomes. A retrospective cohort analysis of 195 early-stage OCCC patients diagnosed between January 2011 and December 2019 at National Taiwan University Hospital was conducted to identify prognostic factors for recurrence, progression-free survival (PFS) and overall survival (OS). Molecular profiling of tumors was performed in a case-controlled cohort matched for adjuvant therapy for biomarker discovery. Multivariate Cox proportional hazard model revealed that paclitaxel-based chemotherapy was associated with better PFS than nonpaclitaxel chemotherapy (HR=0.19, P=.006). The addition of bevacizumab was associated with better PFS, compared to no bevacizumab (HR=0.09, P=.02). Neither showed significant improvement in OS. Recurrence is associated with an Immune-Hot tumor feature (P=.03), the CTLA-4-high subtype (P=.01) and increased infiltration of immune cells in general. The Immune-Hot feature (HR=3.39, P=.005) and the CTLA-4-high subtype (HR=2.13, P=.059) were associated with worse PFS. Immune-Hot tumor features could prognosticate recurrence in early-stage OCCC.