Department of Gynecological Oncology, University Medical Center Aachen, RWTH, Aachen, Germany.
Transl Oncol. 2013 Jun 1;6(3):305-10. doi: 10.1593/tlo.13205. Print 2013 Jun.
In ovarian cancer, new therapeutic strategies are needed because the vast majority of patients develop a recurrence and resistance to platinum derivates. Attached to the AGO-OVAR2.11 study investigating the multityrosine kinase inhibitor sunitinib in recurrent platinum refractory ovarian cancers, this translational research project assesses the potential value of serum vascular endothelial growth factor (VEGF), soluble VEGF receptor-3 (sVEGFR-3), and angiopoietin-2 (Ang-2) levels for progression-free survival (PFS).
Longitudinal serum samples were taken while the patient was on study drugs. Serum concentration of VEGF, sVEGFR-3, and Ang-2 was determined by ELISA. The slope of the markers was correlated to the PFS.
Patients showing a decrease in VEGF concentration had a median PFS of 10.5 months [confidence interval (CI), 2.89-12.25] compared to 2.9 months (CI, 1.48-5.32) in the case of an increase (P = .17). The stratified log-rank test showed a trend for longer PFS if a decrease of Ang-2 was observed (P = .089). Dichotomized in absolute decrease or increase, the PFS was 8.4 months (CI, 2.89-12.26) versus 2.7 months (CI, 1.05-5.32), respectively. Patients with a reduction of the sVEGFR-3 concentration had a median PFS of 4.76 months (CI 2.86-10.65) versus 8.61 months (CI, 1.05-not estimable) in patients with an increase of sVEGFR-3. This observation was statistically not significant in the log-rank test (P = .81).
Ang-2 could potentially identify a patient population that might have a better PFS when under anti-angiogenic treatment, like the tyrosine kinase inhibitor sunitinib.
在卵巢癌中，需要新的治疗策略，因为绝大多数患者会出现复发和对铂类衍生物的耐药性。这项转化研究项目是在 AGO-OVAR2.11 研究的基础上进行的，该研究调查了多酪氨酸激酶抑制剂舒尼替尼在复发性铂类耐药性卵巢癌中的应用，评估了血清血管内皮生长因子 (VEGF)、可溶性 VEGF 受体-3 (sVEGFR-3) 和血管生成素-2 (Ang-2) 水平对无进展生存期 (PFS) 的潜在价值。
在患者使用研究药物期间采集纵向血清样本。通过 ELISA 法测定血清 VEGF、sVEGFR-3 和 Ang-2 浓度。标记物的斜率与 PFS 相关。
与 VEGF 浓度增加的患者相比（CI，1.48-5.32），VEGF 浓度降低的患者中位 PFS 为 10.5 个月（CI，2.89-12.25）（P =.17）。分层对数秩检验显示，如果观察到 Ang-2 下降，则 PFS 有延长的趋势（P =.089）。将其分为绝对下降或增加，PFS 分别为 8.4 个月（CI，2.89-12.26）和 2.7 个月（CI，1.05-5.32）。sVEGFR-3 浓度降低的患者中位 PFS 为 4.76 个月（CI，2.86-10.65），而 sVEGFR-3 升高的患者中位 PFS 为 8.61 个月（CI，1.05-未估计）。对数秩检验未发现这一观察结果具有统计学意义（P =.81）。
Ang-2 可能可以确定一个亚组患者，他们在接受抗血管生成治疗（如酪氨酸激酶抑制剂舒尼替尼）时可能有更好的 PFS。
