Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, Osaka, Japan.
Gynecol Oncol. 2019 May;153(2):312-319. doi: 10.1016/j.ygyno.2019.02.010. Epub 2019 Mar 8.
Recently, we established new histopathological subtypes of high-grade serous ovarian cancer (HGSOC) that include the mesenchymal transition (MT) type, the immune reactive (IR) type, the solid and proliferative (SP) type and the papillo-glandular (PG) type. Furthermore, we identified that the mesenchymal transcriptome subtype might be sensitive to taxane. We investigated whether these different histopathological subtypes of HGSOC require individualized chemotherapy for optimal treatment.
We conducted the Japanese Gynecologic Oncology Group (JGOG) 3016A1 study, wherein we collected hematoxylin and eosin slides (total n = 201) and performed a histopathological analysis of patients with HGSOC registered in the JGOG3016 study, which compared the efficacy of conventional paclitaxel and carboplatin (TC) and dose-dense TC (ddTC). We analyzed the differences in progression-free survival (PFS) and overall survival (OS) among the four histopathological subtypes. We then compared the PFS between the TC group and the ddTC group for each histopathological subtype.
There were significant differences in both PFS and OS among the four histopathological subtypes (p = 0.001 and p < 0.001, respectively). Overall, the MT subtype had the shortest PFS (median 1.4 y) and OS (median 3.6 y). In addition, the MT subtype had a longer PFS in the ddTC group (median 1.8 y) than in the TC group (median 1.2 y) (p = 0.01). Conversely, the other types had no significant difference in PFS when the two regimens were compared.
The MT type of HGSOC is sensitive to taxane; therefore, the ddTC regimen is recommended for this histopathological subtype.
最近，我们建立了高级别浆液性卵巢癌（HGSOC）的新组织病理学亚型，包括间质转化（MT）型、免疫反应（IR）型、实体和增殖（SP）型和乳头-腺体型（PG）型。此外，我们发现间质转录组亚型可能对紫杉烷敏感。我们研究了这些不同的 HGSOC 组织病理学亚型是否需要个体化化疗以获得最佳治疗效果。
我们进行了日本妇科肿瘤学组（JGOG）3016A1 研究，其中收集了 HGSOC 患者的苏木精和伊红切片（总数 n=201），并对 JGOG3016 研究中登记的 HGSOC 患者进行了组织病理学分析，该研究比较了常规紫杉醇加卡铂（TC）和剂量密集 TC（ddTC）的疗效。我们分析了四种组织病理学亚型之间无进展生存期（PFS）和总生存期（OS）的差异。然后，我们比较了每个组织病理学亚型中 TC 组和 ddTC 组的 PFS。
四种组织病理学亚型之间的 PFS 和 OS 均存在显著差异（p=0.001 和 p<0.001）。总体而言，MT 亚型的 PFS（中位数 1.4y）和 OS（中位数 3.6y）最短。此外，ddTC 组 MT 亚型的 PFS 长于 TC 组（中位数 1.8y 比 1.2y）（p=0.01）。相反，当比较两种方案时，其他类型在 PFS 方面没有显著差异。
HGSOC 的 MT 型对紫杉烷敏感；因此，推荐该组织病理学亚型使用 ddTC 方案。
