News in Brief: Copy number variant risk score better for predicting OS in ovarian cancer; Systemic therapy can be deferred in metastatic renal cell carcinoma; Tamoxifen contraception advice extended by TGA

1 Jul 2021

Copy number variant risk score better for predicting OS in ovarian cancer

A risk score based on copy number variants (CNV) for predicting overall survival in patients with ovarian cancer has been shown to be stronger than current ovarian cancer genomic biomarkers and available clinical features.

The genetic association study of 564 patients with serous ovarian cancer identified 13 genome regions, comprising 14 alterations, as significantly associated with risk.

Patients classified as high-, standard-, and low-risk  had median OS estimates of 2.9 (95% CI, 2.3-3.2) years, 4.1 (95% CI, 3.7-4.8) years, and 5.7 (95% CI, 4.7-7.4) years, respectively (P < .001).

Meanwhile associated 5-year survival estimates in each group were 15% (95% CI, 10%-22%), 36% (95% CI, 29%-46%), and 53% (95% CI, 45%-62%).

The composite risk score was independent of total CNV burden, total mutational burden, BRCA status, and open-source genome-wide DNA repair deficiency signatures. The score also had more discriminatory ability to prognosticate overall survival than age, clinical stage, grade, and race combined and was strongly additive to significant clinical features.

The University of California researchers say external validation of the CNV risk score could be pursued via existing FDA-approved assays.

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Systemic therapy can be deferred in metastatic renal cell carcinoma

Active surveillance appears to be a safe strategy in patients with metastatic renal cell carcinoma, a Canadian study suggests.

Results from cohorts of 364 patients who started treatment  more than six months after their initial diagnosis and 489 who never started systemic therapy showed that both overall survival (hazard ratio 0.58; P < .0001) and time to treatment failure (HR 0.72; P = .0002) were greater than a  cohort of 827 patients who received immediate systemic treatment.

The 5-year OS probability was significantly greater for the active surveillance cohort than for immediate treatment (70% vs. 33.6%; P < .0001).

The median time on active surveillance was 14.2 months (range, 6-71), according to results published in Clinical Genitourinary Cancer.


TGA extends contraception advice for tamoxifen

The TGA has extended its advised contraception/no pregnancy period for women on tamoxifen from two months to nine months after end of treatment.

The agency said the selective oestrogen receptor modulator indicated for treatment of breast cancer is contraindicated in pregnancy and women of child-bearing potential should be advised to use barrier or other non-hormonal contraceptive methods if they are sexually active, both during treatment and for nine months after treatment has ended.

“This change is based on US FDA guidance for genotoxic pharmaceuticals which recommends a minimum contraception period of six months plus five elimination half-lives after cessation of therapy,” the TGA’s website said.

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