Ovarian cancer: TILs and HRD status predict OS with surgery

  • Morse CB & al.
  • Gynecol Oncol
  • 22 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Presence of CD3+ tumor-infiltrating lymphocytes (TILs) and homologous recombination deficiency (HRD) was associated with greatest improvement in OS in patients with ovarian cancer who underwent primary surgery.
  • Differences in tumor microenvironment can lead to differential responses.

Why this matters

  • Immunotherapies may be more effective in patients with HRD and with high TILs.

Study design

  • 250 patients with carcinoma of the ovary, fallopian tube, or peritoneum underwent primary surgery.
  • Funding: Wendy Feuer Research Fund for the Prevention and Treatment of Ovarian Cancer.

Key results

  • 39.2% of patients had HRD.
  • High CD3+ TILs were present in 65.3% of HRD vs 43.4% of non-HRD patients.
  • High CD68+ TAMs were present in 66.3% of HRD vs 50.7% of non-HRD patients; CD68+ TAM scores had no effect on OS.
  • Median OS was significantly longer in patients with HRD vs non-HRD (65.4 vs 40.6 months; HR, 0.56; 95% CI, 0.41-0.78).
  • Median OS was 54.6 months in patients with HRD+low CD3 score and 46.0 months with no HRD+high CD3 score.
  • Greatest improvement in median OS was observed in patients with HRD and high CD3+ TILs (70.9 vs 35.8 months; aHR, 0.38; 95% CI, 0.25-0.59).

Limitations

  • Number of patients with HRD and BRCA1/2 mutations was low.

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