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Research Paper|Volume 7, Issue 12|pp 1066—1074

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

Claire Falandry1, Béatrice Horard2, Amandine Bruyas3, Eric Legouffe4, Jacques Cretin5, Jérôme Meunier6, Jérôme Alexandre7, Valérie Delecroix8, Michel Fabbro9, Marie-Noëlle Certain10, Raymonde Maraval-Gaget11, Eric Pujade-Lauraine7, Eric Gilson12, Gilles Freyer13
  • 1Geriatrics and Oncology Unit, HCL Cancer Institute, LBMC, CarMEN Laboratory, Lyon 1 University, Lyon, France
  • 2LBMC, ENS/Lyon, Lyon 1 University,CGphiMC Lyon 1 University, Lyon, France
  • 3Oncology Unit, Lyon Sud University Hospital, Lyon University, Pierre-Bénite, France
  • 4Clinique Valdegour, Department of Medical Oncology, Nîmes, France
  • 5Clinique Bonnefon, Oncology and Radiotherapy Department, Alès, France
  • 6Centre Hospitalier Régional d'Orléans, Department of Medical Oncology, Orléans, France
  • 7Paris Descartes University, AP-HP, Hôpitaux Universitaires Paris Centre, Site Hôtel Dieu, Paris, France
  • 8Clinique Mutualiste de l'Estuaire, Cité Sanitaire, Department of Medical Oncology, Saint-Nazaire, France
  • 9Institut du Cancer Montpellier, Medical Oncology, Montpellier, France
  • 10Centre Hospitalier d'Auxerre, Department of Medical Oncology, Auxerre, France
  • 11Lyon Sud University Hospital, Pierre-Bénite, France
  • 12LBMC, Lyon 1 University, IRCAN, CNRS UMR 7284, INSERM U1081, Nice Sophia-Antipolis University; CHU of Nice, Nice, France
  • 13HCL Cancer Institute, Department of Medical Oncology, Lyon 1 University, Lyon, France
Received: September 6, 2015Accepted: October 30, 2015Published: December 3, 2015
https://doi.org/10.18632/aging.100840

Copyright: © 2015 Falandry et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Purpose Age 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 methods An 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. Results TL (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). Conclusion This exploratory study identifies TL as predictive factor of decreased treatment completion, SAE risk, unplanned hospital admissions and OS after adjustment on FIGO stage.