1. Multiplex profiling identifies distinct local and systemic alterations during intraperitoneal chemotherapy for ovarian cancer: An NRG Oncology/Gynecologic Oncology Group Study
- Author
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Ashley Stuckey, Heather A. Lankes, Robert P. Edwards, Wiam Bshara, Mary Strange, Michael J. Birrer, Joan Brozick, Joan L. Walker, Amit A. Lugade, Kathleen N. Moore, Kunle Odunsi, George C. Tseng, Angela Omilian, Anda M. Vlad, Tianzhou Ma, and Shannon Grabosch
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Paclitaxel ,medicine.medical_treatment ,Pilot Projects ,Gynecologic oncology ,Carcinoma, Ovarian Epithelial ,Article ,Carboplatin ,03 medical and health sciences ,Peritoneal cavity ,Catheters, Indwelling ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,Tumor Microenvironment ,medicine ,Ascitic Fluid ,Humans ,Neoplasms, Glandular and Epithelial ,Biomarker Analysis ,Aged ,Randomized Controlled Trials as Topic ,Whole blood ,Ovarian Neoplasms ,Chemotherapy ,business.industry ,Peritoneal fluid ,Obstetrics and Gynecology ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Bevacizumab ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Female ,Ovarian cancer ,business - Abstract
Objectives Ovarian cancer leads to abdominal carcinomatosis and late stage (III/IV) diagnosis in 75% of patients. Three randomized phase III trials have demonstrated that intraperitoneal (IP) chemotherapy improves outcomes in epithelial ovarian cancer. While IP treatment is validated by clinical trials, there is a poor understanding of the mechanism(s) leading to the survival advantage other than the increased concentration of cytotoxic drugs within the tumor microenvironment. A better understanding of this process through analysis of dynamic biomarkers should promote novel approaches that may enhance tumor clearance. We propose this pilot study to confirm the feasibility of collecting serial peritoneal samples from implanted catheters in women receiving IP chemotherapy. We believe these specimens may be used for multiplex analysis to reveal unique biomarker fluctuations when compared to peripheral blood. Methods From 13 women participating on GOG 252, 30 whole blood, 12 peritoneal fluid (PF), and 20 peritoneal wash (PW) with 30mL saline were obtained. Samples were requested prior to the first three chemotherapy cycles. Samples were assessed for volume, cell populations, protein, RNA, and miRNA content changes. Results Median volume for PF was 1.6mL and 3.1mL for PW. PW is a dilution of PF capable of capturing measurable biomarkers. Peritoneal aspirates contain a unique profile of biomarkers distinct from blood. miRNA undergo earlier alteration with chemotherapy than genes. Flow cytometry does not adequately capture biomarker fluctuations. Conclusions As a proof of principle study, this trial provides evidence that sampling the peritoneal cavity can be adapted for biomarker analysis.
- Published
- 2017
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