Mutated p53 portends improvement in outcomes when bevacizumab is combined with chemotherapy in advanced/recurrent endometrial cancer: An NRG Oncology study

Gynecol Oncol. 2021 Apr;161(1):113-121. doi: 10.1016/j.ygyno.2021.01.025. Epub 2021 Feb 2.

Abstract

Background: Successfully combining targeted agents with chemotherapy is an important future goal for cancer therapy. However, an improvement in patient outcomes requires an enhanced understanding of the tumor biomarkers that predict for drug sensitivity. NRG Oncology/Gynecologic Oncology Group (GOG) Study GOG-86P was one of the first attempts to combine targeted agents (bevacizumab or temsirolimus) with chemotherapy in patients with advanced endometrial cancer. Herein we performed exploratory analyses to examine the relationship between mutations in TP53, the most commonly mutated gene in cancer, with outcomes on GOG-86P.

Methods: TP53 mutational status was determined and correlated with progression-free survival (PFS) and overall survival (OS) on GOG-86P.

Results: Mutations in TP53 were associated with improved PFS and OS for patients that received bevacizumab as compared to temsirolimus (PFS: HR 0.48, 95% CI 0.31, 0.75; OS: HR: 0.61, 95% CI 0.38, 0.98). By contrast, there was no statistically significant difference in PFS or OS between arms for cases with WT TP53.

Conclusions: This exploratory study suggests that combining chemotherapy with bevacizumab, but not temsirolimus, may enhance PFS and OS for patients whose tumors harbor mutant p53. These data set the stage for larger clinical studies evaluating the potential of TP53 mutational status as a biomarker to guide choice of treatment for endometrial cancer patients. Clintrials.gov: NCT00977574.

Keywords: Bevacizumab; Chemotherapy; Endometrial cancer; p53.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / administration & dosage
  • Carboplatin / administration & dosage
  • Clinical Trials, Phase II as Topic
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / genetics*
  • Endometrial Neoplasms / pathology
  • Epothilones / administration & dosage
  • Female
  • Genes, p53
  • Humans
  • Mutation*
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / genetics*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Progression-Free Survival
  • Randomized Controlled Trials as Topic
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives
  • Survival Rate
  • Treatment Outcome
  • Tumor Suppressor Protein p53 / genetics*

Substances

  • Angiogenesis Inhibitors
  • Epothilones
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Bevacizumab
  • temsirolimus
  • Carboplatin
  • ixabepilone
  • Paclitaxel
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT00977574