Dr Lou on the Predictive and Prognostic Utility of Tumor Stroma Proportion in Ovarian Cancer

Emil Lou, MD, PhD, FACP, medical oncologist, neuro-oncologist, gastrointestinal oncologist, associate professor of medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota Medical School, discusses the predictive and prognostic value of tumor stroma proportion (TSP) for patient survival outcomes and chemoresistance in ovarian cancer, according to retrospective study.

Investigators conducted this confirmatory prognostic study which built upon prior research indicating the predictive and prognostic value of TSP in ovarian cancer, and aimed to determine whether patients with a higher TSP spent less time on chemotherapy due to the development of chemoresistance, Lou begins.

Findings published in JAMA Network Open indicated that TSP is a consistent and reproducible marker for survival outcomes and resistance to standard platinum-based chemotherapy in high-grade serous ovarian cancer, he reports. In the Tübingen cohort (n = 192), higher TSP levels were linked to increased resistance to platinum-based chemotherapy, accompanied by shorter progression-free survival (PFS; HR, 1.586; 95% CI, 1.093-2.302; P = .02) and overall survival (OS; HR, 1.867; 1.249-2.789; P = .002). However, no significant correlations were observed between TSP levels and chemoresistance, PFS, or OS in The Cancer Genome Atlas cohort (n = 103). Notably, patients with chemoresistant tumors were twice as likely to exhibit high TSP vs those with chemosensitive tumors (HR, 2.861; 95% CI, 1.256-6.515; P = .01).

These findings are consistent with prior research conducted by Lou and colleagues, confirming a statistically significant association between lower TSP levels and worse OS, in addition to heightened chemoresistance. Overall, patients with high TSP experienced a shorter duration of effective chemotherapy before disease progression or recurrence, Lou reiterates.

The study supports the use of TSP as a predictive biomarker strongly correlated with chemoresistance and prognostic marker of poorer outcomes in ovarian cancer patients, he emphasizes. Further validation and integration of TSP into routine clinical care could ultimately help identify patients with ovarian cancer who are most likely to benefit from standard treatments, Lou concludes.