Chemotherapy-induced neutropenia as a biomarker of survival in advanced ovarian carcinoma: an exploratory study of the gynecologic oncology group
Open accessAbstract
Objective To determine whether chemotherapy-induced neutropenia (C-iN) is associated with improved survival in a population of primary advanced ovarian cancer and peritoneal carcinoma patients treated with a carboplatin plus paclitaxel chemotherapy backbone.Methods A post-hoc exploratory analysis of Gynecologic Oncology Group (GOG) protocol 182 was performed. Landmark analysis was conducted on all patients with progression-free survival >18weeks from the time of study entry. Neutropenia was defined as the absolute neutrophil count <1000mm(3). The occurrence of C-iN was analyzed according to demographic, clinicopathologic, and therapeutic intent, including age, body surface area, and treatment arm. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate independent prognostic factors and to estimate their effects on PFS and OS.Results Neutropenic data was available for 3447 patients. Neutropenic (n=3196) and non-neutropenic groups (n=251) were similar in demographic and clinicopathologic characteristics. Neutropenic patients experienced significantly improved survival compared to non-neutropenic patients with the adjusted hazard ratio (HR) for death being 0.86 (95% confidence interval 0.74-0.99; p=0.041). There was no survival benefit associated with any of the treatment arms among patients with C-iN.Conclusion These data suggest that C-iN may represent a clinical biomarker associated with a survival advantage for patients with untreated advanced ovarian cancer. The absence of C-iN may indicate under-dosing and ultimately attenuated anti-neoplastic effect in vulnerable populations.
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Chemotherapy-induced neutropenia has predicted improved survival rates among cancer patients.
“chemotherapy induced neutropenia has also predicted improved survival rates among cancer patients [12–17]”
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- Authors
- Tewari, K. S., Java, J. J., Gatcliffe, T. A., Bookman, M. A., & Monk, B. J.
- Affiliations
- University of California, Irvine Medical Center (US)
- Roswell Park Comprehensive Cancer Center (US)
- University of Arizona Cancer Center (US)
- Creighton University (US)
- Corresponding author
- Tewari, Krishnansu S.
- Venue
- Gynecologic Oncology
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 133
- Issue
- 3
- Pages
- 439-445
- ISSN
- 0090-8258 (ISSN-L)
- OpenAlex
- W4238318603
- Cited by
- 39
- References
- 38
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 2 · 2014: 1
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Locations
- Gynecologic Oncology (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- chemotherapy-induced neutropenia, advanced ovarian cancer, peritoneal cancer, carboplatin, paclitaxel, prognostic factors, survival, progression-free survival, overall survival, chemotherapy dosing
- MeSH terms
- Aged, Antineoplastic Combined Chemotherapy Protocols, Adenocarcinoma, Mucinous, Female, Humans, Middle Aged, Neutropenia, Ovarian Neoplasms, Peritoneal Neoplasms, Proportional Hazards Models, Carboplatin, Treatment Outcome, Paclitaxel, Adenocarcinoma, Clear Cell, Cystadenocarcinoma, Serous, Disease-Free Survival, Kaplan-Meier Estimate
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