Body composition and inflammation variables as the potential prognostic factors in epithelial ovarian cancer treated with Olaparib

Xingzi Guo; Jie Tang; Haifeng He; Lian Jian; Ouyang Qiang; Yongzhi Xie

doi:10.3389/fonc.2024.1359635

Body composition and inflammation variables as the potential prognostic factors in epithelial ovarian cancer treated with Olaparib

Front Oncol. 2024 Apr 25:14:1359635. doi: 10.3389/fonc.2024.1359635. eCollection 2024.

Authors

Xingzi Guo¹, Jie Tang¹, Haifeng He², Lian Jian³, Ouyang Qiang¹, Yongzhi Xie²

Affiliations

¹ Department of Gynecologic Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
² Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, China.
³ Department of Radiology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.

Abstract

Background: Epithelial ovarian cancer (EOC) is a significant cause of mortality among gynecological cancers. While Olaparib, a PARP inhibitor, has demonstrated efficacy in EOC maintenance therapy, individual responses vary. This study aims to assess the prognostic significance of body composition and systemic inflammation markers in EOC patients undergoing initial Olaparib treatment.

Methods: A retrospective analysis was conducted on 133 EOC patients initiating Olaparib therapy. Progression-free survival (PFS) was assessed through Kaplan-Meier analysis and Cox proportional hazards regression. Pre-treatment computed tomography images were utilized to evaluate body composition parameters including subcutaneous adipose tissue index (SATI), visceral adipose tissue index (VATI), skeletal muscle area index (SMI), and body mineral density (BMD). Inflammatory markers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), serum albumin, and hemoglobin levels, were also measured.

Results: The median follow-up duration was 16 months (range: 5-49 months). Survival analysis indicated that high SATI, high VATI, high SMI, high BMD, low NLR, and low PLR were associated with decreased risk of disease progression (all p < 0.05). Multivariate analysis identified several factors independently associated with poor PFS, including second or further lines of therapy (HR = 2.16; 95% CI = 1.09-4.27, p = 0.027), low VATI (HR = 3.79; 95% CI = 1.48-9.70, p = 0.005), low SMI (HR = 2.52; 95% CI = 1.11-5.72, p = 0.027), low BMD (HR = 2.36; 95% CI = 1.22-4.54, p = 0.010), and high NLR (HR = 0.31; 95% CI = 0.14-0.69, p = 0.004). Subgroup analysis in serous adenocarcinoma patients revealed distinct prognostic capabilities of SATI, VATI, SMI, PLR, and NLR.

Conclusion: Body composition and inflammation variables hold promise as predictors of therapeutic response to Olaparib in EOC patients. Understanding their prognostic significance could facilitate tailored treatment strategies, potentially improving patient outcomes.

Keywords: body composition; epithelial ovarian cancer; inflammation variables; poly (ADP-ribose) polymerase inhibitors; progression free survival.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study is funded by the Hunan Provincial Natural Science Foundation of China (Grant No.2022JJ40247).