Therapeutic options for mucinous ovarian carcinoma

Kylie L. Gorringe, Dane Cheasley, Matthew J. Wakefield, Georgina L. Ryland, Prue E. Allan, Kathryn Alsop, Kaushalya C. Amarasinghe, Sumitra Ananda, David D.L. Bowtell, Michael Christie, Yoke Eng Chiew, Michael Churchman, Anna DeFazio, Sian Fereday, C. Blake Gilks, Charlie Gourley, Alison M. Hadley, Joy Hendley, Sally M. Hunter, Scott H. KaufmannCatherine J. Kennedy, Martin Köbel, Cecile Le Page, Jason Li, Richard Lupat, Orla M. McNally, Jessica N. McAlpine, Jan Pyman, Simone M. Rowley, Carolina Salazar, Hugo Saunders, Timothy Semple, Andrew N. Stephens, Niko Thio, Michelle C. Torres, Nadia Traficante, Magnus Zethoven, Yoland C. Antill, Ian G. Campbell, Clare L. Scott

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: Mucinous ovarian carcinoma (MOC) is an uncommon ovarian cancer histotype that responds poorly to conventional chemotherapy regimens. Although long overall survival outcomes can occur with early detection and optimal surgical resection, recurrent and advanced disease are associated with extremely poor survival. There are no current guidelines specifically for the systemic management of recurrent MOC. We analyzed data from a large cohort of women with MOC to evaluate the potential for clinical utility from a range of systemic agents. Methods: We analyzed gene copy number (n = 191) and DNA sequencing data (n = 184) from primary MOC to evaluate signatures of mismatch repair deficiency and homologous recombination deficiency, and other genetic events. Immunohistochemistry data were collated for ER, CK7, CK20, CDX2, HER2, PAX8 and p16 (n = 117–166). Results: Molecular aberrations noted in MOC that suggest a match with current targeted therapies include amplification of ERBB2 (26.7%) and BRAF mutation (9%). Observed genetic events that suggest potential efficacy for agents currently in clinical trials include: KRAS/NRAS mutations (66%), TP53 missense mutation (49%), RNF43 mutation (11%), ARID1A mutation (10%), and PIK3CA/PTEN mutation (9%). Therapies exploiting homologous recombination deficiency (HRD) may not be effective in MOC, as only 1/191 had a high HRD score. Mismatch repair deficiency was similarly rare (1/184). Conclusions: Although genetically diverse, MOC has several potential therapeutic targets. Importantly, the lack of response to platinum-based therapy observed clinically corresponds to the lack of a genomic signature associated with HRD, and MOC are thus also unlikely to respond to PARP inhibition.

Original languageEnglish (US)
Pages (from-to)552-560
Number of pages9
JournalGynecologic oncology
Volume156
Issue number3
DOIs
StatePublished - Mar 2020

Keywords

  • Genomic
  • Molecular targeted therapy
  • Ovarian cancer
  • Precision oncology
  • Sequencing
  • Therapy

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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