Platelet count as a biomarker for monitoring treatment response and disease recurrence in recurrent epithelial ovarian cancer

Abstract

Objectives: We sought to determine the impact of pretreatment plasma platelet levels, dimerized plasmin fragment (D-dimer) and fibrinogen in recurrent epithelial ovarian cancer (EOC) and the impact of platelet levels on SKOV3 cell lines growth and responsiveness to chemotherapy. Methods: Under approval of ethical committee, we identified 104 women with recurrent EOC who underwent treatment between January 2010 and February 2015. Reviewing clinical, laboratory, and pathologic records from this retrospective cohort, we analyzed the correlation between pretreatment plasma D-dimer, fibrinogen, platelet levels and clinicopathological parameters, progression free survival (PFS) and overall survival (OS). Inco-culture experiments human ovarian cancer SKOV3 cell lines were used to test the effect of platelet levels on tumor growth and responsiveness to docetaxel. Results: Of the 104 recurrent EOC, thrombocytosis at diagnosis and the decrease of platelet count by less than 25% after primary therapy were associated with worse median progression free survival (P = 0.003;P = 0.021) and median overall survival (P = 0.009;P = 0.009). Mean platelet levels declined at the end of primary therapy(P < 0.001) and rose at recurrence(P = 0.007). In multivariate analysis, elevated platelet levels at primary therapy and the decrease of platelet count less than 25% after primary therapy were unfavorable prognostic factor for PFS(P = 0.022; P = 0.015) and OS(P = 0.013;P = 0.007) in recurrent EOC, but elevated plasma D-dimer and fibrinogen were not. In SKOV-3 ovarian cancer cell lines, suitable concentration platelet co-culture protected against apoptosis (P < 0.05). Conclusions: Platelet count during treatment could be used as a biomarker used for monitoring the disease recurrence and predicting treatment response. And platelet with suitable concentration co-culture protected against apoptosis in SKOV3 cell line, which may explain clinical observations.

Predictive value of the systemic immune-inflammation index for the efficacy of neoadjuvant chemotherapy and prognosis in patients with stage III ovarian cancer—a retrospective cohort study

“…Recently, the concept of the SII has been proposed, which comprehensively takes the influence of platelets into consideration based on the ratio of neutrophils to lymphocytes. Platelets are small pieces of cytoplasm that detach from the cytoplasm of mature megakaryocytes in bone marrow, and participate in tumor growth, tumor cell extravasation, tumor metastasis, which can inhibit tumor cell apoptosis and maintain the integrity of tumor blood vessels ( 21 - 23 ). Previous studies showed that the progression-free survival and overall survival of ovarian cancer patients with a high SII (>612) were shortened, and a high level of SII was an independent factor resulting in poor prognosis ( 11 ).…”

Interactions between Platelets and Tumor Microenvironment Components in Ovarian Cancer and Their Implications for Treatment and Clinical Outcomes

“…Multiple clinical trials have assessed the impact of antiplatelet agents, alone or with chemotherapeutic drugs, on preventing or treating ovarian cancer. Significantly, platelet counts or platelet-derived molecules can be used as diagnostic, prognostic, or predictive biomarkers [380].…”

Platelets: The Emerging Clinical Diagnostics and Therapy Selection of Cancer Liquid Biopsies

“… Hu Q et al, 32 Prostate cancer The results of the study indicate that performance status (PS) and platelet count are independent prognostic factors for evaluating disease-specific survival (DSS) in patients with metastatic prostate cancer receiving endocrine therapy. Shimodaira K et al, 33 Diffuse large B-cell lymphoma (DLBCL) Platelet count and albumin level are useful prognostic factors, and their combined use can even predict the survival of elderly patients with DLBCL. Ochi Y et al, 34 Acute myeloid leukemia (AML) Platelet count can predict the survival rate of patients with moderate-risk AML.…”