Chengyan Luo

Chemotherapy‐Induced Myelosuppression in Patients With gBRCA ‐m Epithelial Ovarian Cancer: A Retrospective Study

ABSTRACT Background Existing evidence indicates that germline BRCA mutation (gBRCA‐m) may increase chemotherapy sensitivity and toxicity. However, its role in chemotherapy‐induced myelosuppression (CIM) remains unclear. We conducted this study to investigate the influence of gBRCA‐m on CIM incidence and severity in patients with epithelial ovarian carcinoma (EOC). Methods Patients with EOC treated at the First Affiliated Hospital of Nanjing Medical University from January 2018 to August 2023 were classified into two groups: gBRCA‐m and gBRCA wild‐type. Chemotherapy regimen and myelosuppression data were retrospectively reviewed. Multivariate analysis assessed the association between gBRCA‐m and CIM incidence and severity in patients with EOC receiving first‐line chemotherapy. Results Sixty six (27%) of 242 included patients were gBRCA‐m carriers. The median times to myelosuppression onset and the most severe occurrence were significantly shorter for patients with gBRCA‐m (6.0 vs. 27.0 days, p  < 0.001; 73.5 vs. 121.0 days, p  < 0.001). Patients with gBRCA‐m had a greater likelihood of Grade IV (GIV) myelosuppression at onset (aOR = 5.585, 95% CI = 1.621–19.241). During the most severe myelosuppression, patients with gBRCA‐m experienced more pronounced decreases in white blood cells (1.83 × 10 9 vs. 2.33*10 9  cells/L, p  = 0.002), neutrophils (0.73 × 10 9 vs. 1.08 × 10 9  cells/L, p  = 0.001), haemoglobin levels (90.41 vs. 94.14 g/L, p  = 0.017) and platelets (81.62 × 10 9 vs. 97.63 × 10 9  cells/L, p  = 0.001) and were more prone to febrile GIV myelosuppression (aOR = 2.882, 95% CI = 1.071–7.754). The incidences of chemotherapy dose reduction (aOR = 4.322, 95% CI = 2.048–9.124) and delay (aOR = 6.045, 95% CI = 2.266–16.126) were significantly greater in patients with gBRCA‐m. An analysis across all chemotherapy cycles indicated that patients with gBRCA‐m had greater risks of GIII (aOR = 2.356, 95% CI = 1.770–3.137), GIV (aOR = 2.324, 95% CI = 1.685–3.207) myelosuppression and GIV myelosuppression with fever (aOR = 2.097, 95% CI = 1.077–4.083), as well as a greater incidence of chemotherapy dose reduction (aOR = 2.606, 95% CI = 1.785–3.805) and delay (aOR = 4.118, 95% CI = 2.213–7.663). Conclusions EOC patients with gBRCA‐m experienced earlier and more severe CIM, highlighting the need for careful monitoring and tailored management.

Identification of prognostic factors and construction of nomogram to predict cancer‐specific survival for patients with ovarian granulosa cell tumors

AbstractBackgroundOvarian granulosa cell tumors (OGCTs) feature low incidence, indolent growth and late recurrence. Treatment for recurrent OGCTs is challenging.MethodsThe present study was designed to explore the prognostic factors and establish a nomogram to predict cancer‐specific survival (CSS) for OGCTs patients. Enrolled in the study were 1459 eligible patients in the Surveillance, Epidemiology, and End Results (SEER) database, who were randomized to the training (n = 1021) or testing set (n = 438) at a ratio of 7:3. Univariate and multivariate Cox regression analyses were employed to screen the prognostic factors. The predictors were determined by using the Least absolute shrinkage and selection operator (LASSO) regression analysis. The model was constructed via the Cox proportional hazards risk regression analysis. The performance and clinical value of the nomograms was assessed with C‐index, calibration plots, and decision curve analysis.ResultsAge, pTNM stage, tumor size, surgery of the primary tumor, surgery of regional lymph nodes (LNs), residual disease after surgery, and chemotherapy were considered as significant predictive factors for CSS in OGCTs patients. After screening, the prognostic factors except surgery of regional LNs and chemotherapy were employed to build the nomogram. With desirable discrimination and calibration, the nomogram was more powerful in predicting CSS than the American Joint Committee on Cancer staging system in clinical use.ConclusionThis novel prognostic nomogram, which comprises a stationary nomogram and a web‐based calculator, offers convenience for clinicians in personalized decision‐making including optimal treatment plans and prognosis assessments for OGCTs patients.