Telomere length is a prognostic biomarker in elderly advanced ovarian cancer patients: a multicenter GINECO study

Abstract

PurposeAge induces a progressive decline in functional reserve and impacts cancer treatments. Telomere attrition leads to tissue senescence. We tested the hypothesis that telomere length (TL) could predict patient vulnerability and outcome with cancer treatment.Patients and methodsAn ancillary study in the Elderly Women GINECO Trial 3 was performed to evaluate the impact of geriatric covariates on survival in elderly advanced ovarian cancer patients receiving six cycles of carboplatin. TL was estimated from peripheral blood at inclusion using standard procedures.ResultsTL (in base pairs) was estimated for 109/111 patients (median 6.1 kb; range [4.5-8.3 kb]). With a cut-off of 5.77 kb, TL discriminated two patient groups, long telomere (LT) and short telomeres (ST), with significantly different treatment completion rates of 0.80 (95%CI [0.71-0.89]) and 0.59 (95%CI [0.41-0.76]), respectively (odds ratio [OR]=2.8, p=0.02). ST patients were at higher risk of serious adverse events (SAE, OR=2.7; p=0.02) and had more unplanned hospital admissions (OR=2.1; p=0.08). After adjustment on FIGO stage, TL shorter than 6 kb was a risk factor of premature death (HR=1.57; p=0.06).ConclusionThis exploratory study identifies TL as predictive factor of decreased treatment completion, SAE risk, unplanned hospital admissions and OS after adjustment on FIGO stage.

Mitochondrial mRNA transcripts predict overall survival, tumor recurrence and progression in serous ovarian cancer: Companion diagnostics for cancer therapy

“…Thus, telomerase-high ovarian CSCs are the most energetically-activated, migratory and proliferative cell sub-population [ 6 ]. These findings suggest a mechanistic interpretation for why long telomere length (a specific marker of high telomerase activity) is strictly correlated with metastasis disease progression and poor outcome in ovarian tumors and other cancer types [ 8 , 9 ].…”

Impact of baseline telomere length on survival and chemotherapy related toxicity in breast cancer patients receiving (neo)adjuvant anthracycline containing chemotherapy

“…However, rate of side effects was also low in this study, at least for some of the toxicities under analysis. In contrast, one study significantly correlated shorter leukocyte TL with higher risk of non-hematological toxicity in elderly ovarian cancer patients, but did not find such association for hematological events [33] . The cohort of this study received carboplatin instead of FEC or FEC-D, so it is possible that the observed correlation is drug-specific.…”

Biologic Mechanisms Linked to Prognosis in Ovarian Cancer that May Be Affected by Aging

“…Short telomere was associated with age, and with treatment completion rates (p=0.02), serious adverse events (p=0.02), and a trend association with unplanned hospital admissions (p=0.08), and OS (p=0.06). There was a trend association with geriatric vulnerability parameters 110.…”