High-grade ovarian cancer: gene signature may boost prognostication

  • Millstein J & al.
  • Ann Oncol
  • 1 Sep 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • A novel gene expression signature called OTTA-SPOT (Ovarian Tumor Tissue Analysis Consortium–Stratified Prognosis of Ovarian Tumors) could improve prognostication in patients with high-grade serous ovarian cancer.

Why this matters

  • Prognostic gene expression signature tests are available for other cancers, such as breast cancer, but none are available for ovarian cancer.

Study design

  • A 101-gene expression signature was developed and validated using pretreatment tumor tissue from 3769 women with high-grade serous ovarian cancer treated on 21 studies.
  • Funding: National Institutes of Health/National Cancer Institute; Canadian Institutes for Health Research; Department of Defense Ovarian Cancer Research Program. 

Key results

  • Adding the signature to age and stage alone improved the prediction of 2- and 5-year OS. 
  • The area under the curve increased from 0.61 to 0.69 for 2-year OS and from 0.62 to 0.75 for 5-year OS (nonoverlapping 95% CIs).
  • Each standard deviation increase in the gene expression score was associated with a more than doubling of the mortality risk (HR, 2.35; P<.001>
  • OS by gene expression score quintiles: 9.5, 5.4, 3.8, 3.2, and 2.3 years for patients in the first, second, third, fourth, and fifth quintiles, respectively.

Limitations

  • Heterogeneity by ancestry or ethnicity was not in the scope of the study.