title: Human leukocyte antigen class I expression is an independent prognostic factor in advanced ovarian cancer resistant to first-line platinum chemotherapy.
abstract: BACKGROUND
  Loss of HLA class I is important in ovarian cancer prognosis but its role as a prognostic indicator in relation to therapy remains unproven. We studied the prognostic potential of this antigen and its significance in relation to platinum therapy.
  
  
  METHODS
  A total of 157 primary ovarian cancers were assessed for HLA class I immunohistochemically and linked to a comprehensive database of clinicopathological variables, treatment details, and platinum sensitivity.
  
  
  RESULTS
  Tumours expressing high levels of HLA class I had significantly improved survival (P=0.044). There was a 19-month difference in the median overall survival between tumours with high and low antigen expression. HLA class I antigen expression, stage, and platinum sensitivity were independently predictive of prognosis on multivariate analysis. HLA class I antigen was shown to be expressed at higher levels in patients with good overall survival in platinum-resistant patients (P=0.042). HLA class I significantly correlated with overall survival on multivariate analyses (P=0.034).
  
  
  CONCLUSIONS
  Low-level HLA class I expression is an independent prognostic indicator of poor clinical outcome in ovarian cancer. The survival advantage of patients with platinum-resistant tumours expressing high levels of HLA class I suggests that immunotherapy may be of use in these ovarian cancers resistant to standard chemotherapy.
authors.affiliation: Academic and Clinical Department of Oncology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: M
authors.initials: M
authors.lastname: Shehata
authors.forename: A
authors.initials: A
authors.lastname: Mukherjee
authors.forename: S
authors.initials: S
authors.lastname: Deen
authors.forename: A
authors.initials: A
authors.lastname: Al-Attar
authors.forename: L G
authors.initials: LG
authors.lastname: Durrant
authors.forename: S
authors.initials: S
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D005260:Female; D015395:Histocompatibility Antigens Class I / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000473:pathology; D010984:Platinum / Q000627:therapeutic use*; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents; D015395:Histocompatibility Antigens Class I; D010984:Platinum