Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Section of Gynecologic Oncology, Oklahoma City, OK, United States of America.
NRG Oncology SDMC, CTD Division, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America.
Gynecol Oncol. 2021 May;161(2):382-388. doi: 10.1016/j.ygyno.2021.02.032. Epub 2021 Mar 10.
Increasing measures of adiposity have been correlated with poor oncologic outcomes and a lack of response to anti-angiogenic therapies. Limited data exists on the impact of subcutaneous fat density (SFD) and visceral fat density (VFD) on oncologic outcomes. This ancillary analysis of GOG-218, evaluates whether imaging markers of adiposity were predictive biomarkers for bevacizumab (bev) use in epithelial ovarian cancer (EOC).
There were 1249 patients (67%) from GOG-218 with imaging measurements. SFD and VFD were calculated utilizing Hounsfield units (HU). Proportional hazards models were used to assess the association between SFD and VFD with overall survival (OS).
Increased SFD and VFD showed an increased HR for death (HR per 1-SD increase 1.12, 95% CI:1.05-1.19 p = 0.0009 and 1.13, 95% CI: 1.05-1.20 p = 0.0006 respectively). In the predictive analysis for response to bev, high VFD showed an increased hazard for death in the placebo group (HR per 1-SD increase 1.22, 95% CI: 1.09-1.37; p = 0.025). However, in the bev group there was no effect seen (HR per 1-SD increase: 1.01, 95% CI: 0.90-1.14) Median OS was 45 vs 47 months in the VFD low groups and 36 vs 42 months in the VFD high groups on placebo versus bev, respectively.
High VFD and SFD have a negative prognostic impact on patients with EOC. High VFD appears to be a predictive marker of bev response and patients with high VFD may be more likely to benefit from initial treatment with bev.
肥胖程度的增加与肿瘤不良预后和抗血管生成治疗反应不足相关。关于皮下脂肪密度（SFD）和内脏脂肪密度（VFD）对肿瘤学结果的影响，数据有限。本项 GOG-218 的辅助分析评估了肥胖的影像学标志物是否是上皮性卵巢癌（EOC）患者接受贝伐珠单抗（bev）治疗的预测生物标志物。
GOG-218 中有 1249 例患者（67%）有影像学测量数据。利用亨氏单位（HU）计算 SFD 和 VFD。比例风险模型用于评估 SFD 和 VFD 与总生存期（OS）之间的关联。
SFD 和 VFD 的增加与死亡的 HR 增加有关（每增加 1-SD 的 HR 分别为 1.12，95%CI：1.05-1.19，p=0.0009 和 1.13，95%CI：1.05-1.20，p=0.0006）。在预测 bev 反应的分析中，高 VFD 显示安慰剂组死亡的风险增加（每增加 1-SD 的 HR 为 1.22，95%CI：1.09-1.37；p=0.025）。然而，在 bev 组中未观察到效果（每增加 1-SD 的 HR：1.01，95%CI：0.90-1.14）。VFD 低值组的中位 OS 为 45 个月，VFD 高值组为 36 个月，安慰剂组与 bev 组分别为 47 个月和 42 个月。
高 VFD 和 SFD 对 EOC 患者有不良预后影响。高 VFD 似乎是 bev 反应的预测标志物，高 VFD 的患者可能更有可能从初始 bev 治疗中获益。
