title: Telomere length is a prognostic biomarker in elderly advanced ovarian cancer patients: a multicenter GINECO study.
abstract: OBJECTIVE
  Age induces a progressive decline in functional reserve and impacts cancer treatments. Telomere attrition leads to tissue senescence. We tested the hypothesis that telomere length (TL) could predict patient vulnerability and outcome with cancer treatment.
  
  
  METHODS
  An ancillary study in the Elderly Women GINECO Trial 3 was performed to evaluate the impact of geriatric covariates on survival in elderly advanced ovarian cancer patients receiving six cycles of carboplatin. TL was estimated from peripheral blood at inclusion using standard procedures.
  
  
  RESULTS
  TL (in base pairs) was estimated for 109/111 patients (median 6.1 kb; range [4.5-8.3 kb]). With a cut-off of 5.77 kb, TL discriminated two patient groups, long telomere (LT) and short telomeres (ST), with significantly different treatment completion rates of 0.80 (95% CI [0.71-0.89]) and 0.59 (95% CI [0.41-0.76]), respectively (odds ratio [OR]=2.8, p=0.02). ST patients were at higher risk of serious adverse events (SAE, OR=2.7; p=0.02) and had more unplanned hospital admissions (OR=2.1; p=0.08). After adjustment on FIGO stage, TL shorter than 6 kb was a risk factor of premature death (HR=1.57; p=0.06).
  
  
  CONCLUSIONS
  This exploratory study identifies TL as predictive factor of decreased treatment completion, SAE risk, unplanned hospital admissions and OS after adjustment on FIGO stage.
authors.affiliation: Geriatrics and Oncology Unit, HCL Cancer Institute, LBMC, CarMEN Laboratory, Lyon 1 University, Lyon, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Falandry
authors.affiliation: LBMC, ENS/Lyon, Lyon 1 University,CGphiMC Lyon 1 University, Lyon, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Horard
authors.affiliation: Oncology Unit, Lyon Sud University Hospital, Lyon University, Pierre-Bénite, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Bruyas
authors.affiliation: Clinique Valdegour, Department of Medical Oncology, Nîmes, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Legouffe
authors.affiliation: Clinique Bonnefon, Oncology and Radiotherapy Department, Alès, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cretin
authors.affiliation: Centre Hospitalier Régional d'Orléans, Department of Medical Oncology, Orléans, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Meunier
authors.affiliation: Paris Descartes University, AP-HP, Hôpitaux Universitaires Paris Centre, Site Hôtel Dieu, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.affiliation: Clinique Mutualiste de l'Estuaire, Cité Sanitaire, Department of Medical Oncology, Saint-Nazaire, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Delecroix
authors.affiliation: Institut du Cancer Montpellier, Medical Oncology, Montpellier, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Fabbro
authors.affiliation: Centre Hospitalier d'Auxerre, Department of Medical Oncology, Auxerre, France.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Certain
authors.affiliation: Lyon Sud University Hospital, Pierre-Bénite, France.
authors.forename: Raymonde
authors.initials: R
authors.lastname: Maraval-Gaget
authors.affiliation: Paris Descartes University, AP-HP, Hôpitaux Universitaires Paris Centre, Site Hôtel Dieu, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Pujade-Lauraine
authors.affiliation: LBMC, Lyon 1 University, IRCAN, CNRS UMR 7284, INSERM U1081, Nice Sophia-Antipolis University; CHU of Nice, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Gilson
authors.affiliation: HCL Cancer Institute, Department of Medical Oncology, Lyon 1 University, Lyon, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Freyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015415:Biomarkers; D016190:Carboplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000378:metabolism*; D011247:Pregnancy; D059505:Telomere Homeostasis / Q000502:physiology*; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D016190:Carboplatin
keywords: elderly; geriatric; ovarian cancer; prognostic factor; telomere