title: Molecular cytogenetics as a clinical test for prognostic and predictive biomarkers in newly diagnosed ovarian cancer.
abstract: BACKGROUND
  There is a clinical need for routinely available genomic biomarker testing in newly diagnosed ovarian cancer. In the current study we performed molecular cytogenetics using a validated array based comparative genomic hybridization (array CGH) assay to screen for the presence of predictive and prognostic biomarkers in archival diagnostic tissue from ovarian cancer patients. We hypothesized that biomarkers of high-risk disease would be detectable in tumor samples from patients with treatment refractory, advanced disease, and would be detected less frequently in tumor samples from patients with more favorable outcomes. In addition, we predicted that the use of a genome-wide copy number analysis (CNA) testing platform would enable us to identify novel potentially targetable chromosomal alterations of therapeutic significance in a percentage of cases.
  
  
  METHODS
  Formalin-fixed paraffin-embedded tissue (FFPE) tumor bank specimens were retrieved from the initial surgical resection for 18 ovarian cancer patients. Molecular cytogenetics was performed by array CGH for the detection of somatic chromosomal alterations associated with high-risk disease including amplifications of the CCNE1 and HER2 genes. Genomic risk stratification results were correlated with available clinical data. CGH data from each patient's tumor genome was also surveyed for the presence of potentially targetable aberrations. Relevant therapeutic agents and open studies for investigational drugs were reported for each patient.
  
  
  RESULTS
  High-risk genomic alterations were identified in 12/18 (67%) of cases and all patients with high-risk markers had advanced, treatment refractory disease. Three tumors with minimal genomic changes had no high-risk markers and were from patients with Stage I/II disease that had been completely resected and under surveillance for recurrence. Eleven patients (61%) had at least one potentially targetable genomic alteration including CCNE1, HER2, KRAS gene amplifications, and somatic BRCA1 and/or BRCA2 gene deletions. Bi-allelic PTEN gene deletion was detected in one patient's tumor.
  
  
  CONCLUSIONS
  Clinical genomic profiling of ovarian tumors by array CGH augments pathologic grade and stage to help stratify newly diagnosed ovarian cancer into high and low-risk disease. This personalized genomic information can also help guide treatment planning and disease monitoring by identifying novel potentially targetable genomic alterations that can be used by clinicians to choose rational directed therapies for patients with chemo-resistant disease.
authors.affiliation: Start Center for Cancer Care, San Antonio, TX, USA. shelly.gunn@stoh.com.
authors.forename: Shelly
authors.initials: S
authors.lastname: Gunn
authors.forename: Xavier
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authors.lastname: Reveles
authors.forename: Korrie
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authors.lastname: Weldon
authors.forename: Andres
authors.initials: A
authors.lastname: Barrera
authors.forename: Mariam
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authors.lastname: Ishaque
authors.forename: Dale
authors.initials: D
authors.lastname: Taylor
authors.forename: Chris
authors.initials: C
authors.lastname: McCaskill
authors.forename: Jaeweon
authors.initials: J
authors.lastname: Kim
authors.forename: Rashmi
authors.initials: R
authors.lastname: Shah
authors.forename: Mansoor
authors.initials: M
authors.lastname: Mohammed
authors.forename: Todd
authors.initials: T
authors.lastname: Barry
authors.forename: Brianne
authors.initials: B
authors.lastname: Kaiser
authors.forename: Amita
authors.initials: A
authors.lastname: Patnaik
authors.forename: Anthony
authors.initials: A
authors.lastname: Tolcher