B89
VEGF expression as a biomarker to predict response to platinum based chemotherapy in epithelial ovarian cancer
Ghazna Sidddiqui, AC Wong Te Fong, KJ Rolfe, S Hadjat, WMN Reid, JCC Crow, C Perrett, AB Maclean
Royal Free and University College Medical School, London, UK
Background
Vascular endothelial growth factor (VEGF) is an angiogenic factor and a key promoter of tumour progression in patients with epithelial ovarian cancer (EOC). At present, anti-angiogenic agents are under evaluation for the treatment of advanced disease.
Aim
This study was undertaken to examine whether there is an association between VEGFA expression in the primary and paired metastatic tumour in response to platinum chemotherapy in epithelial ovarian cancer.
Method
The study cohort consisted of 66 consecutive with advanced EOC (FIGO stages 3-4) at the Royal Free University Hospital, London. The ovarian cancer tissue and their matched omental metastases were stained by standard immunohistochemical techniques for VEGFA expression. Expression of the protein was correlated with platinum sensitivity.
Results
The mean age of the 66 patients was 58 years (range 22 to 82). 45 patients were found to have platinum sensitive disease (75%), the remaining 21 being platinum resistant (25%). Of the platinum resistant group, 81% had a high VEGF score in the matched metastatic tumour compared to only 29% in the platinum sensitive group.
Discussion
Cytoreduction together with a combination of taxane and a platinum is the standard of care for EOC. Despite this, 50% of advanced disease will relapse. Furthermore approximately 15-20% of EOC is resistant to platinum chemotherapy. VEGF over-expression is associated with ascites formation and malignant progression. Expression of VEGF may serve as a biomarker to predict a subgroup of patients with platinum resistance disease and hence be of clinical and therapeutic relevance. We have shown that platinum resistant EOC was associated with a higher proportion of high VEGF expression compared to platinum sensitive group.
Conclusion
Angiogenic evaluation in patients with EOC may play a role in predicting a subgroup of patients who are platinum resistant and may therefore be more amenable to anti-angiogenic therapy.
