Cytoreductive surgery and HIPEC (hyperthermic intraperitoneal chemotherapy) in combined treatment of ovarian cancer: time for the beginning of personalized therapy?
Curr Issues Pharm Med Sci., Vol. 32, No. 3, 154-159
Roman Yarema1*, Nataliya Volodko1, Taras Fetsych1, Myron Оhorchak2,
Orest Petronchak2, Yuriy Mylyan2, Halyna Makukh3
1 Danylo Halytsky Lviv National Medical University, Department of Oncology and Medical Radiology, Lviv, Ukraine
2 Lviv State Oncological Regional Treatment and Diagnostic Center, Lviv, Ukraine
3 SI “Institute of Hereditary Pathology Ukrainian National Academy of Medical Sciences”, Lviv, Ukraine
Background and objectives. During the two past decades, a new therapeutic approach to ovarian cancer (OC) has been developed. This combines cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, almost no data exist regarding the utility of biomarkers of morphological heterogeneity as prognostic factors in such patients.
Methods. A retrospective study of the effectiveness of CRS and HIPEC was carried out in 59 patients with ovarian cancer. Biomarkers of morphological heterogeneity of OC were studied as prognostic factors: OC pathogenic types (based on the identification of р53 mutated gene protein expression) and homologous recombination deficit (basing on the identification of BRCA 1 gene expression status).
Results. The survival of patients reliably differed with the division into two pathogenetic OC types established by immunohistochemistry: the median disease-free survival of type I OC patients was 14±1.7 months, type ІІ – 8±1.6 months (р = 0.007); the median overall survival of type I OC patients was 23.5±6.7 months, type ІІ – 12±1.9 months (р = 0.017). The median overall survival of patients with the somatic mutation of BRCA 1 gene and complete cytoreduction was 22±4.8 months, and without the somatic mutation of BRCA 1 gene – 12±3.3 months (р = 0.047).
Conclusions. These data demonstrate that identification of the pathogenetic type of OC and BRCA 1 status may be useful for the personalized therapy of ovarian cancer patients treated with CRS/HIPEC.
carcinomatosis, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, p53, BRCA 1.