Predictive blood-based biomarkers in patients with epithelial ovarian cancer treated with carboplatin and paclitaxel with or without bevacizumab: Results from GOG-0218

Angeles Alvarez Secord, Kirsten Bell Burdett, Kouros Owzar, David Tritchler, Alexander B. Sibley, Yingmiao Liu, Mark D. Starr, J. Chris Brady, Heather A. Lankes, Herbert I. Hurwitz, Robert S. Mannel, Krishnansu S. Tewari, David M. O'Malley, Heidi Gray, Jamie N. Bakkum-Gamez, Keiichi Fujiwara, Matthew Boente, Wei Deng, Robert A. Burger, Michael J. BirrerAndrew B. Nixon

Research output: Contribution to journalArticle

Abstract

Purpose: GOG-0218, a double-blind placebo-controlled phase III trial, compared carboplatin and paclitaxel with placebo, bevacizumab followed by placebo, or bevacizumab followed by bevacizumab in advanced epithelial ovarian cancer (EOC). Results demonstrated significantly improved progression-free survival (PFS), but no overall survival (OS) benefit with bevacizumab. Blood samples were collected for biomarker analyses. Experimental Design: Plasma samples were analyzed via multiplex ELISA technology for seven prespecified biomarkers [IL6, Ang-2, osteopontin (OPN), stromal cell-derived factor-1 (SDF-1), VEGF-D, IL6 receptor (IL6R), and GP130]. The predictive value of each biomarker with respect to PFS and OS was assessed using a protein marker by treatment interaction term within the framework of a Cox proportional hazards model. Prognostic markers were identified using Cox models adjusted for baseline covariates. Results: Baseline samples were available from 751 patients. According to our prespecified analysis plan, IL6 was predictive of a therapeutic advantage with bevacizumab for PFS (P ¼ 0.007) and OS (P ¼ 0.003). IL6 and OPN were found to be negative prognostic markers for both PFS and OS (P < 0.001). Patients with high median IL6 levels (dichotomized at the median) treated with bevacizumab had longer PFS (14.2 vs. 8.7 months) and OS (39.6 vs. 33.1 months) compared with placebo. Conclusions: The inflammatory cytokine IL6 may be predictive of therapeutic benefit from bevacizumab when combined with carboplatin and paclitaxel. Aligning with results observed in patients with renal cancer treated with antiangiogenic therapies, it appears plasma IL6 may also define those patients with EOC more or less likely to benefit from the addition of bevacizumab to standard chemotherapy.

Original languageEnglish (US)
Pages (from-to)1288-1296
Number of pages9
JournalClinical Cancer Research
Volume26
Issue number6
DOIs
StatePublished - Mar 15 2020

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Secord, A. A., Burdett, K. B., Owzar, K., Tritchler, D., Sibley, A. B., Liu, Y., Starr, M. D., Chris Brady, J., Lankes, H. A., Hurwitz, H. I., Mannel, R. S., Tewari, K. S., O'Malley, D. M., Gray, H., Bakkum-Gamez, J. N., Fujiwara, K., Boente, M., Deng, W., Burger, R. A., ... Nixon, A. B. (2020). Predictive blood-based biomarkers in patients with epithelial ovarian cancer treated with carboplatin and paclitaxel with or without bevacizumab: Results from GOG-0218. Clinical Cancer Research, 26(6), 1288-1296. https://doi.org/10.1158/1078-0432.CCR-19-0226