title: Serum TRAIL levels in patients with epithelial ovarian cancer or primary peritoneal cancer treated with neoadjuvant chemotherapy. A pilot study.
abstract: OBJECTIVE
  The study attempted to evaluate the kinetics of changes in serum TRAIL levels as a potential predictive and prognostic factor in patients with epithelial ovarian cancer (EOC) or primary peritoneal carcinoma (PPC), eligible for an interval debulking surgery (IDS).
  
  
  METHODS
  17 patients with primary inoperable EOC or PPC in FIGO Stage IIIC or IV who underwent an exploratory operation were enrolled to the study. Serum TRAIL levels were determined by ELISA method (DIACLONE, Besancon Cedex, France) before and after two courses of neoadjuvant chemotherapy (NAC) based on paclitaxel and platinum analogue (cisplatin or carboplatin). The control group consisted of six healthy volunteers. The median difference in concentration of TRAIL (dTRAIL) between the initial marking and after two courses of NAC in each patient was 192 pg/ml and it was used for dichotomization of the test group.
  
  
  RESULTS
  Suboptimal interval debulking surgery (IDS) was performed in 23.5% (4/17) and optimal IDS in 76.5% (13/17) patients. TRAIL concentration before chemotherapy did not differ significantly between patients with EOC or PPC [1426.96 +/- 321.06 pg/ml (mean +/- SD) (U = 26, p = 0.08)] and the control group [1160.40 +/- 256.39 pg/ml (mean +/- SD. After two courses of NAC serum TRAIL concentration level was 1247.49 +/- 378.46 pg/ml (mean +/- SD). The difference was significant (Z = 2.44, p = 0.0147). Statistical analysis showed that dTRAIL did not significantly influence either extent of IDS (U = 35, p = 0.0962) or time to progression (log-rank test, p = 0.1185), overall survival (log-rank test, p = 0.1973) and response to treatment according to RECIST criteria (U = 35.5, p = 0.9616).
  
  
  CONCLUSIONS
  Serum TRAIL concentration levels changed significantly during NAC. However, it seems that the concentration of this protein has no critical value as a predictive or prognostic factor in patients with EOC or PPC.
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Military Institute of Medicine, Warsaw, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Gasowska-Bodnar
authors.forename: L
authors.initials: L
authors.lastname: Bodnar
authors.forename: A
authors.initials: A
authors.lastname: Synowiec
authors.forename: M
authors.initials: M
authors.lastname: Jerzak
authors.forename: G
authors.initials: G
authors.lastname: Wcislo
authors.forename: M
authors.initials: M
authors.lastname: Smoter
authors.forename: C
authors.initials: C
authors.lastname: Szczylik
authors.forename: W
authors.initials: W
authors.lastname: Baranowski
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D010865:Pilot Projects; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
chemical_list: D053221:TNF-Related Apoptosis-Inducing Ligand; C505653:TNFSF10 protein, human