Biomarker analysis of the MITO2 phase III trial of first-line treatment in ovarian cancer: Predictive value of DNA-PK and phosphorylated ACC

Francesco Perrone, Gustavo Baldassarre, Stefano Indraccolo, Simona Signoriello, Gennaro Chiappetta, Francesca Esposito, Gabriella Ferrandina, Renato Franco, Delia Mezzanzanica, Maura Sonego, Elisabetta Zulato, Gian Franco Zannoni, Vincenzo Canzonieri, Giovanni Scambia, Roberto Sorio, Antonella Savarese, Enrico Breda, P. Scollo, Antonella Ferro, Stefano TamberiAntonio Febbraro, D. Natale, Massimo Di Maio, Daniela Califano, Giosuè Scognamiglio, Domenica Lorusso, Sitvana Canevari, Nunzia Simona Losito, Ciro Gallo, Sandro Pignata

Research output: Contribution to journalArticlepeer-review


Background: No biomarker is available to predict prognosis of patients with advanced ovarian cancer (AOC) and guide the choice of chemotherapy. We performed a prospective-retrospective biomarker study within the MITO2 trial on the treatment of AOC. Patients and methods: MITO2 is a randomised multicentre phase 3 trial conducted with 820 AOC patients assigned carboplatin/paclitaxel (carboplatin: AUC5, paclitaxel: 175 mg/m2, every 3 weeks for 6 cycles) or carboplatin/PLD-pegylated liposomal doxorubicin (carboplatin: AUC5, PLD: 30 mg/m2, every 3 weeks for 6 cycles) as first line treatment. Sixteen biomarkers (pathways of adhesion/invasion, apoptosis, transcription regulation, metabolism, and DNA repair) were studied in 229 patients, in a tissue microarray. Progression-free and overall survival were analysed with multivariable Cox model. Results: After 72 months median follow-up, 594 progressions and 426 deaths were reported; there was no significant difference between the two arms in the whole trial. No biomarker had significant prognostic value. Statistically significant interactions with treatment were found for DNA-dependent protein kinase (DNA-PK) and phosphorylated acetyl-coenzymeA carboxylase (pACC), both predicting worse outcome for patients receiving carboplatin/paclitaxel. Conclusion: These data show that in presence of DNA-PK or pACC overexpression, carboplatin/paclitaxel might be less effective than carboplatin/PLD as first line treatment of ovarian cancer patients. Further validation of these findings is warranted.

Original languageEnglish
Pages (from-to)72654-72661
Number of pages8
Issue number45
Publication statusPublished - 2016


  • DNA-PK
  • Ovarian cancer
  • PACC
  • Phase 3 clinical trial
  • Predictive factors

ASJC Scopus subject areas

  • Oncology


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