Abstract
Most patients with ovarian cancer experience recurrence and develop resistance to platinum-based agents. The diagnosis of platinum resistance based on the platinum-free interval is not always accurate and timely in clinical settings. Herein, we used laser ablation inductively coupled plasma mass spectrometry to visualize the platinum distribution in the ovarian cancer tissues at the time of interval debulking surgery after neoadjuvant chemotherapy in 27patients with advanced high-grade serous ovarian cancer. Two distinct patterns of platinum distribution were observed. Type A (n = 16): platinum accumulation at the adjacent stroma but little in the tumor; type B (n = 11): even distribution of platinum throughout the tumor and adjacent stroma. The type A patients treated post-surgery with platinum-based adjuvant chemotherapy showed significantly shorter periods of recurrence after the last platinum-based chemotherapy session (p = 0.020) and were diagnosed with “platinum-resistant recurrence”. Moreover, type A was significantly correlated with worse prognosis (p = 0.031). Post-surgery treatment with non-platinum-based chemotherapy could be effective for the patients classified as type A. Our findings indicate that the platinum resistance can be predicted prior to recurrence, based on the platinum distribution; this could contribute to the selection of more appropriate adjuvant chemotherapy, which may lead to improves prognoses.
Highlights
Most patients with ovarian cancer experience recurrence and develop resistance to platinum-based agents
The platinum distribution identified by LA-Inductively coupled plasma mass spectrometry (ICP-MS) can be a reasonable biomarker of true platinum resistance at the time of neoadjuvant chemotherapy followed by interval debulking surgery (NAC-IDS) in patients with advanced ovarian cancer and can provide useful information for the selection of the appropriate chemotherapy after operation
Platinum resistance, which is currently defined based on the platinum-free interval (PFI) at the time of recurrence[1,5,18], is a major problem in ovarian cancer treatment[1,3,5]
Summary
Most patients with ovarian cancer experience recurrence and develop resistance to platinum-based agents. We used laser ablation inductively coupled plasma mass spectrometry to visualize the platinum distribution in the ovarian cancer tissues at the time of interval debulking surgery after neoadjuvant chemotherapy in 27patients with advanced highgrade serous ovarian cancer. Abbreviations HGSOC High-grade serous ovarian carcinoma IDS Interval debulking surgery LA-ICP-MS Laser ablation inductively coupled plasma mass spectrometry NAC Neoadjuvant chemotherapy OS Overall survival PFI Platinum-free interval Pt Platinum TFI Treatment-free interval. Whether or not to use platinum-based agents at the time point of a patient’s recurrence depends on the patient’s PFI The problem with this strategy is that it allows for the diagnosis of platinum resistance only at the time of tumor growth[1,4,5]. Novel biomarkers of platinum resistance are needed so that more appropriate drugs can be used for HGSOC earlier in adjuvant treatment, which could prolong the patients’ survival and minimize adverse effects caused by platinum-based a gents[6]
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