Comparison of Survival Outcomes Between Next-Generation Sequencing and Single-Gene Testing in Patients With Advanced Ovarian Cancer in South Korea
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Objectives: Real-world evidence on the clinical outcomes of next-generation sequencing (NGS) has been scarce for advanced ovarian cancer. This study aimed to investigate the real-world effectiveness of NGS compared with conventional single-gene testing (SGT) in advanced ovarian cancer using a nationwide database in South Korea. Methods: In this retrospective cohort study, patients diagnosed with advanced ovarian cancer between March 1, 2017, and December 31, 2018, were included. Patients who received upfront NGS or both NGS and SGT were assigned to the NGS group, and those who received SGT only were assigned to the SGT group. The NGS and SGT groups were matched 1:2 using the propensity score (PS). We compared overall survival (OS) between groups using the Kaplan–Meier method and log-rank test. The Cox proportional hazard model was used to estimate the hazard ratio (HR) for death. Results: Among the 1,724 patients with advanced ovarian cancer, 198 and 336 patients were assigned to the NGS and SGT groups, respectively, after matching. There were no significant differences in OS between the groups in the overall cohort (p=0.731) and the PS-matched cohort (p=0.862). NGS was not associated with a reduced risk of death compared with SGT in the overall cohort (adjusted HR=0.94 [95% confidence interval=0.55–1.60], p=0.810) and the PS-matched cohort (0.94 [0.53–1.65], p=0.820). Conclusion: The use of NGS in all-comers with advanced ovarian cancer is not supported by current real-world population-wide data. Further introduction of more effective treatments guided by genomic alterations may enhance the effectiveness of these strategies.
Abstract
Objectives: Real-world evidence on the clinical outcomes of next-generation sequencing (NGS) has been scarce for advanced ovarian cancer. This study aimed to investigate the real-world effectiveness of NGS compared with conventional single-gene testing (SGT) in advanced ovarian cancer using a nationwide database in South Korea. Methods: In this retrospective cohort study, patients diagnosed with advanced ovarian cancer between March 1, 2017, and December 31, 2018, were included. Patients who received upfront NGS or both NGS and SGT were assigned to the NGS group, and those who received SGT only were assigned to the SGT group. The NGS and SGT groups were matched 1:2 using the propensity score (PS). We compared overall survival (OS) between groups using the Kaplan–Meier method and log-rank test. The Cox proportional hazard model was used to estimate the hazard ratio (HR) for death. Results: Among the 1,724 patients with advanced ovarian cancer, 198 and 336 patients were assigned to the NGS and SGT groups, respectively, after matching. There were no significant differences in OS between the groups in the overall cohort (p=0.731) and the PS-matched cohort (p=0.862). NGS was not associated with a reduced risk of death compared with SGT in the overall cohort (adjusted HR=0.94 [95% confidence interval=0.55–1.60], p=0.810) and the PS-matched cohort (0.94 [0.53–1.65], p=0.820). Conclusion: The use of NGS in all-comers with advanced ovarian cancer is not supported by current real-world population-wide data. Further introduction of more effective treatments guided by genomic alterations may enhance the effectiveness of these strategies.
참고문헌 (17)
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