Article Text

Download PDFPDF

1032 Strong association between pathological response to neoadjuvant chemotherapy, TILs and modeled CA125 KELIM in ovarian carcinomas: CHIVA trial, GINECO
  1. J Pierre-Alexandre1,2,3,4,
  2. S Moret1,2,
  3. O Colomban5,
  4. P Combe3,6,
  5. S Abadie-Lacourtoisie3,7,
  6. J Meunier3,8,
  7. A Floquet3,9,
  8. L Venat-Bouvet3,10,
  9. C Louvet3,11,
  10. L Favier3,12,
  11. P Follana3,13,
  12. JP Lotz3,14,
  13. F Del Piano3,15,
  14. M Leheurteur3,16,
  15. CR Alliot3,17,
  16. G De Rauglaudre3,18,
  17. N Raban3,19,
  18. A Chevalier-Place3,20,
  19. A Leary3,4,21 and
  20. B You3,4,5,22
  1. 1Université de Paris, Faculté de médecine, Paris, France
  2. 2APHP. Centre, Hopital Cochin, Pathology department, Paris, France
  3. 3GINECO, Paris, France
  4. 4GINEGEPS, Paris, France
  5. 5Université Claude Bernard Lyon 1, EA 3738 CICLY, Lyon, France
  6. 6APHP. Centre, Hopital européen Georges Pompidou, Medical Oncology, Paris, France
  7. 7Institut de Cancérologie de l’Ouest – ICO – Site Paul Papin, Medical oncology, Angers, France
  8. 8Centre Hospitalier Régional d’Orléans, Medical oncology, Orléans, France
  9. 9Institut Bergonié, Oncology, Bordeaux, France
  10. 10Centre Hospitalier Universitaire Dupuytren, Medical oncology, Limoges, France
  11. 11Institut Mutualiste Montsouris, Medical oncology, Paris, France
  12. 12Centre Georges François Leclerc, Medical oncology, Dijon, France
  13. 13Centre Antoine Lacassagne, Onco-hematology, Nice, France
  14. 14APHP. Sorbonne Université, Hopital Tenon, Medical oncology, Paris, France
  15. 15Hôpitaux du Léman, Surgery, Thonon-les-Bains, France
  16. 16Centre Henri Becquerel, Medical oncology, Rouen, France
  17. 17Centre Hospitalier Alpes Leman, Oncology, Contamine-sur-Arve, France
  18. 18Institut Sainte-Catherine, Clinical cancerology, Avignon, France
  19. 19CHU de Poitiers – Pôle Régional de Cancérologie – Hôpital de la Milétrie, Oncology, Poitiers, France
  20. 20Centre Oscar Lambret, Gynecology, Lille, France
  21. 21Gustave Roussy, Medical oncology, Villejuif, France
  22. 22Institut de cancérologie des Hospice Civils de Lyon IC-HCL, Medical oncology, CITOHL, Pierre-Bénite, France


Introduction/Background*As stated by ESGO-ESMO, there is a need for indicators of chemotherapy efficacy in ovarian carcinoma patients treated in first-line setting (Colombo et al, IGCS, 2020). The pathological chemotherapy response score (CRS) and the modeled CA-125 KELIM during neo-adjuvant chemotherapy were reported as potential markers. Moreover, changes in tumor infiltrating lymphocytes (TILs) after neo-adjuvant chemotherapy were reported as a prognostic factor (Leary et al, Cancer Immunol Immunother, 2021). We studied the relationships between changes in TILs, the pathological response (pR) and KELIM in patients treated with neo-adjuvant chemotherapy +/- interval debulking surgery (IDS) from CHIVA phase II trial.

Methodology The patients were enrolled in the randomized phase II trial CHIVA (NCT01583322, neo-adjuvant carboplatin-paclitaxel +/- nintedanib, +/- IDS, n=188 patients). KELIM were previously calculated (You et al CCR 2020). The 30 patients with the highest KELIM (very chemosensitive) or the lowest KELIM (poorly chemosensitive) were selected. HE-stained sections from available tissue blocks at baseline and after chemotherapy were analyzed for stromal TILs (sTILs, surface of the tumor stroma occupied by lymphocytes) and intra-epithelial TILs (ieTILs, brisk or non-brisk). The pathological response (pR) was assessed on the most tumoral available tissue block obtained after chemotherapy (good response if extensive fibrous changes with no or isolated tumor cells, or <2 mm cell clusters). Descriptive statistics assessed the relationships between KELIM, TIL changes, and pR.

Result(s)*No relationships between KELIM and TILs infiltrates on baseline tumor samples were found. However, strong associations were found between KELIM and TIL infiltrates after neo-adjuvant chemotherapy for sTILs (median KELIM for sTILs 0-5% vs >5%: 0.28 versus 1.32, P < 0.001) and for ieTILs (median KELIM for ieTILs non-brisk versus brisk: 0.31 versus 1.31, P = 0.04). Similarly, an association was found between KELIM and the quality of pR (median KELIM for patients with poor vs good pR: 0.31 versus 1.32, P = 0.05).

Conclusion*High consistency was found between the modeled CA125 KELIM calculated during the first 100 days of neo-adjuvant chemotherapy and the pathological response, consistent with their values as indicators of the tumor chemosensitivity in first-line setting. Moreover, TILs changes were strongly associated with chemosensitivity, opening hypotheses about the mechanisms of chemosensitivity, and immunotherapy opportunity.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.