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Willing EM, Vollbrecht C, Vössing C, Weist P, Schallenberg S, Herbst JM, Schatz S, Jóri B, Bataillon G, Harter P, Salutari V, Martin AG, Vergote I, Colombo N, Roeper J, Berg T, Berger R, Kah B, Noettrup TJ, Falk M, Arndt K, Polten A, Ray-Coquard I, Selzam F, Pirngruber J, Schmidt S, Hummel M, Tiemann M, Horst D, Sehouli J, Pujade-Lauraine E, Tiemann K, Braicu EI, Heukamp LC. Development of the NOGGO GIS v1 Assay, a Comprehensive Hybrid-Capture-Based NGS Assay for Therapeutic Stratification of Homologous Repair Deficiency Driven Tumors and Clinical Validation. Cancers (Basel) 2023; 15:3445. [PMID: 37444554 DOI: 10.3390/cancers15133445] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
The worldwide approval of the combination maintenance therapy of olaparib and bevacizumab in advanced high-grade serous ovarian cancer requires complex molecular diagnostic assays that are sufficiently robust for the routine detection of driver mutations in homologous recombination repair (HRR) genes and genomic instability (GI), employing formalin-fixed (FFPE) paraffin-embedded tumor samples without matched normal tissue. We therefore established a DNA-based hybrid capture NGS assay and an associated bioinformatic pipeline that fulfils our institution's specific needs. The assay´s target regions cover the full exonic territory of relevant cancer-related genes and HRR genes and more than 20,000 evenly distributed single nucleotide polymorphism (SNP) loci to allow for the detection of genome-wide allele specific copy number alterations (CNA). To determine GI status, we implemented an %CNA score that is robust across a broad range of tumor cell content (25-85%) often found in routine FFPE samples. The assay was established using high-grade serous ovarian cancer samples for which BRCA1 and BRCA2 mutation status as well as Myriad MyChoice homologous repair deficiency (HRD) status was known. The NOGGO (Northeastern German Society for Gynecologic Oncology) GIS (GI-Score) v1 assay was clinically validated on more than 400 samples of the ENGOT PAOLA-1 clinical trial as part of the European Network for Gynaecological Oncological Trial groups (ENGOT) HRD European Initiative. The "NOGGO GIS v1 assay" performed using highly robust hazard ratios for progression-free survival (PFS) and overall survival (OS), as well a significantly lower dropout rate than the Myriad MyChoice clinical trial assay supporting the clinical utility of the assay. We also provide proof of a modular and scalable routine diagnostic method, that can be flexibly adapted and adjusted to meet future clinical needs, emerging biomarkers, and further tumor entities.
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Affiliation(s)
- Eva-Maria Willing
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
| | - Claudia Vollbrecht
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Christine Vössing
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Lungenkrebsmedizin Oldenburg, GbR, 26121 Oldenburg, Germany
| | - Peggy Weist
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Lungenkrebsmedizin Oldenburg, GbR, 26121 Oldenburg, Germany
| | - Simon Schallenberg
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | | | - Stefanie Schatz
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - Balázs Jóri
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - Guillaume Bataillon
- Department of Pathology, Institut Universitaire du Cancer de Toulouse (IUCT) Oncopole, 31100 Toulouse, France
| | | | - Vanda Salutari
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Antonio Gonzáles Martin
- Medical Oncology Department, Clinica Universidad de Navarra, 28027 Madrid, Spain
- GEICO, 28003 Madrid, Spain
| | - Ignace Vergote
- Leuven Cancer Institute, University Hospital Leuven, 3000 Leuven, Belgium
| | - Nicoletta Colombo
- Gynecologic Oncology Program, European Institute of Oncology, 20141 Milan, Italy
- Department of Medicine and Surgery, University of Milan-Biocca (Colombo), 20141 Milan, Italy
| | - Julia Roeper
- Universitätsklinik für Innere Medizin-Onkologie, Cancer Center Oldenburg, Pius-Hospital, Georgstr. 12, 26121 Oldenburg, Germany
| | - Tobias Berg
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - Regina Berger
- Department of Obstetrics and Gynecology, AGO Austria Study Center, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Bettina Kah
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | | | - Markus Falk
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - Kathrin Arndt
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - Andreas Polten
- Agilent Technologies Deutschland GmbH, 71034 Böblingen, Germany
| | - Isabelle Ray-Coquard
- Centre Léon BERARD, and University Claude Bernard Lyon I, 69008 Lyon, France
- ARCAGY GINECO, 75008 Paris, France
| | | | - Judith Pirngruber
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Lungenkrebsmedizin Oldenburg, GbR, 26121 Oldenburg, Germany
| | | | - Michael Hummel
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Markus Tiemann
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
| | - David Horst
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- German Cancer Consortium (DKTK) Partner Site Berlin, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Jalid Sehouli
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
- Charité University Medicine, Joint Medical Faculty of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology with Center of Oncological Surgery and European Competence Center for Ovarian Cancer, 10117 Berlin, Germany
| | | | - Katharina Tiemann
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
| | - Elena Ioana Braicu
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
- Lungenkrebsmedizin Oldenburg, GbR, 26121 Oldenburg, Germany
- Charité University Medicine, Joint Medical Faculty of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Gynecology with Center of Oncological Surgery and European Competence Center for Ovarian Cancer, 10117 Berlin, Germany
- Department of Obstetrics and Gynecology, Stanford University, Stanford, CA 94305, USA
| | - Lukas C Heukamp
- Institut für Hämatopathologie Hamburg, 22547 Hamburg, Germany
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie NOGGO e. V., 13359 Berlin, Germany
- Lungenkrebsmedizin Oldenburg, GbR, 26121 Oldenburg, Germany
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Fujiwara K, Fujiwara H, Yoshida H, Satoh T, Yonemori K, Nagao S, Matsumoto T, Kobayashi H, Bourgeois H, Harter P, Mosconi AM, Vazquez IP, Reinthaller A, Fujita T, Rowe P, Pujade-Lauraine E, Ray-Coquard I. Olaparib plus bevacizumab as maintenance therapy in patients with newly diagnosed, advanced ovarian cancer: Japan subset from the PAOLA-1/ENGOT-ov25 trial. J Gynecol Oncol 2021; 32:e82. [PMID: 34378365 PMCID: PMC8362816 DOI: 10.3802/jgo.2021.32.e82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The addition of maintenance olaparib to bevacizumab demonstrated a significant progression-free survival (PFS) benefit in patients with newly diagnosed, advanced ovarian cancer in the PAOLA-1/ENGOT-ov25 trial (NCT02477644). We evaluated maintenance olaparib plus bevacizumab in the Japan subset of PAOLA-1. METHODS PAOLA-1 was a randomized, double-blind, phase III trial. Patients received maintenance olaparib tablets 300 mg twice daily or placebo twice daily for up to 24 months, plus bevacizumab 15 mg/kg every 3 weeks for up to 15 months in total. This prespecified subgroup analysis evaluated investigator-assessed PFS (primary endpoint). RESULTS Of 24 randomized Japanese patients, 15 were assigned to olaparib and 9 to placebo. After a median follow-up for PFS of 27.7 months for olaparib plus bevacizumab and 24.0 months for placebo plus bevacizumab, median PFS was 27.4 versus 19.4 months, respectively (hazard ratio [HR]=0.34; 95% confidence interval [CI]=0.11-1.00). In patients with tumors positive for homologous recombination deficiency, the HR for PFS was 0.57 (95% CI=0.16-2.09). Adverse events in the Japan subset were generally consistent with those of the PAOLA-1 overall population and with the established safety and tolerability profiles of olaparib and bevacizumab. CONCLUSION Results in the Japan subset of PAOLA-1 support the overall conclusion of the PAOLA-1 trial demonstrating that the addition of maintenance olaparib to bevacizumab provides a PFS benefit in patients with newly diagnosed, advanced ovarian cancer. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02477644.
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Affiliation(s)
- Keiichi Fujiwara
- Saitama Medical University International Medical Center, Saitama, Japan.
| | | | - Hiroyuki Yoshida
- Saitama Medical University International Medical Center, Saitama, Japan
| | | | | | | | | | | | - Hughes Bourgeois
- Centre Jean Bernard - Clinique Victor Hugo, GINECO, Le Mans, France
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