The Immune Landscape of Epithelial Ovarian Cancer

Oncology Institute of Southern Switzerland74 enrolled

Overview

This is a single center prospective observational study to characterize the immune landscape of newly diagnosed epithelial ovarian cancer (OC). Patients with newly diagnosed epithelial OC will be enrolled in 4 different cohorts: A) Newly diagnosed high grade serous or endometroid OC undergoing primary debulking surgery; B) Newly diagnosed high grade serous or endometroid OC undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery; C) Rare subtypes of epithelial OC (low grade serous, low grade endometrioid, clear cell, mucinous or carcinosarcoma) undergoing primary debulking surgery; D) Rare subtypes of epithelial OC (low grade serous, low grade endometrioid, clear cell, mucinous or carcinosarcoma) undergoing NACT followed by interval debulking surgery. A cohort of women undergoing adnexectomy for benign pathology will be enrolled (cohort E) for comparative analysis. Enrolled patients will be asked to provide the following biological samples at specified time points: archival and fresh tumor tissue, peripheral blood samples, rectal and vaginal swabs, ascites (when present). The main aim of the study is to characterize the immune landscape of epithelial OC in tumor tissue and peripheral blood and correlate the presence of myeloid-derived suppressive cells (MDSCs) and other immune infiltrates and of the systemic immune response with progression free interval (PFI) in epithelial OC.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Epithelial Ovarian Cancer

Interventions

Eligibility

Sex: FEMALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion criteria cohort A-D: * Suspicious diagnosis of epithelial ovarian cancer (subsequent histologically confirmation required) * Plan to undergo a surgical procedure for the management of epithelial ovarian cancer or recurrent ovarian cancer previously treated with conventional treatment and involved in the trial as group A-D * ≥18 years old * ECOG Performance Status ≤ 2 * Written informed consent Inclusion criteria cohort E: * Indication for adnexectomy for a benign gynecological condition * ≥18 years old * ECOG Performance Status ≤ 2 * Written informed consent Exclusion criteria cohort A-E: * Other active concomitant neoplasms that might confound the results of the planned analysis. * Ongoing active autoimmune disease requiring treatment or condition of immune deficiency * Ongoing chronic treatment with steroids or other immune suppressive agents at the time of study entry

Outcomes

Primary Outcomes

Characterization of the immune cells infiltrate

Expression of multiple immune cell markers will be assessed in samples from different subtypes of epithelial ovarian cancer by flow cytometric analysis. Percentages of individual immune cell populations among total tumor-infiltrating immune cells will be evaluated.

Time frame: At the time of diagnosis in the tumor tissue and on blood. For patients receiving chemotherapy, assessment on blood after cycle 3 and 6

Secondary Outcomes

To define the prognostic value of the immune cells infiltrate

The prognostic value of the immune cell populations identified by flow cytometry will be evaluated by calculating the correlation coefficient between the percentage of the immune cell population and the progression-free interval.

Time frame: From diagnosis until disease progression or study termination, whichever will occur first