Transcriptome signature for the identification of bevacizumab responders in ovarian cancer

Abstract

The standard of care for ovarian cancer comprises cytoreductive surgery, followed by adjuvant platinum-based chemotherapy plus taxane therapy and maintenance therapy with the antiangiogenic compound bevacizumab and/or a PARP inhibitor. Nevertheless, there is currently no clear clinical indication for the use of bevacizumab, highlighting the urgent need for biomarkers to assess the response to bevacizumab. In the present study, based on a novel RNA-seq dataset (n=181) and a previously published microarray-based dataset (n=377), we have identified an expression signature potentially associated with benefit from bevacizumab addition and assumed to reflect cancer stemness acquisition driven by activation of CTCFL. Patients with this signature demonstrated improved overall survival when bevacizumab was added to standard chemotherapy in both novel (HR=0.41(0.23-0.74), adj.p-value=7.70e-03) and previously published cohorts (HR=0.51(0.34-0.75), adj.p-value=3.25e-03), while no significant differences in survival explained by treatment were observed in patients negative for this signature. In addition to the CTCFL signature, we found several other reproducible expression signatures which may also represent biomarker candidates not related to established molecular subtypes of ovarian cancer and require further validation studies based on additional RNA-seq data.