Women with advanced ovarian cancer who express a certain tumor antigen will likely experience a shorter progression-free survival (PFS) and overall survival (OS) than those without the antigen, according to research published in Gynecologic Oncology (June 2017;145:420-425).
Ovarian cancer is the most lethal gynecological malignancy in the United States. Despite treatment advances in recent years, survival rates have improved only marginally. A potentially targetable antigen in ovarian cancer cells is NY-ESO-1.
J Brian Szender, MD, MPH, department of gynecologic oncology, Roswell Park Cancer Institute, and colleagues assessed 1002 patients with ovarian cancer for NY-ESO-1 expression from January 2002 through June 2016. Participants were a median age of 61 years. About 62.8% of participants had stage IIIc ovarian cancer, and 13.2% had stage IV ovarian cancer.
Clinicopathologic outcomes, including PFS and OS based on NY-ESO-1 expression, were evaluated, and Cohen's kappa tested agreement between expression tests.
Overall, NY-ESO-1 expression was detected in the tumors of 40.7% of participants (NY-ESO-1+). Additionally, the researchers identified baseline humoral response in 19% of 689 patients who were tested.
Results of the study indicated that NY-ESO-1-positive patients tended to be older, have an advanced stage of cancer, and be less likely to have a complete response to initial therapy. NY-ESO-1-positive patients also had more serous histotype and more grade 3 tumors.
In addition, NY-ESO-1-positive patients tended to demonstrate shorter PFS and significantly shorter OS. However, a subset analysis of NY-ESO-1-positive patients who received immunotherapy targeting the antigen had showed improved OS by more than 2 years.
“This study is the first demonstration of an association between NY-ESO-1 expression and an aggressive cancer phenotype,” the researchers concluded. “The relatively high expression frequency of NY-ESO-1 in ovarian cancer patients coupled with the poor clinical outcomes in NY-ESO-1+ patients reveals an underappreciated need for targeted therapy against this antigen.”
Researchers conducted further research to assess immunotherapy agents targeting NY-ESO-1 in ovarian cancer. Preliminary evidence suggests that such therapy improves OS, but further research is needed.—Christina Vogt