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Joyce F. Liu, MD, MPH
Joyce F. Liu, MD, MPH
Posted: Friday, June 13, 2025
According to a study presented at the 2025 AACR Annual Meeting, although the Ovarian Tumor Tissue Analysis consortium Stratified Prognosis of Ovarian Tumors (OTTA-SPOT) gene expression signature has demonstrated prognostic potential for high-grade serous ovarian cancers, hazard ratios (HR) were weaker in Black patients. The OTTA-SPOT score was developed and validated in a predominately White population, despite Black women being 30% more likely to die of ovarian cancer than White women. Lindsay J. Collin, PhD, MPH, of Emory University, Atlanta, Georgia, and colleagues sought to evaluate the performance of the OTTA-SPOT score across both Black and White patients.
The researchers analyzed tumor samples from 272 Black and 316 White patients with high-grade serous ovarian cancers, using RNA extracted from formalin-fixed paraffin-embedded tissues. They normalized the data to match the NanoString platform and applied RNA sequencing to assess expression of 101 genes comprising the OTTA-SPOT score. Scores were assigned using a weighted linear combination of gene expression, age, and cancer stage.
In White patients, the lowest quintile had an HR of 0.62 (95% confidence interval [CI] = 0.42–0.92), and the highest quintile had an HR of 2.21 (95% CI = 1.48–3.30); the corresponding HRs in Black patients were 0.98 (95% CI = 0.61–1.56) and 1.13 (95% CI: 0.72–1.77), indicating “attenuated performance.” Median survival also varied by OTTA-SPOT quintile. Among White patients, survival ranged from 7.5 years in the lowest quintile to 2.8 years in the highest, and in Black patients it ranged from 6.0 to 3.4 years. Additionally, more cases of high-grade serous ovarian cancer in Black patients were classified in the highest quintile overall.
The study concluded that while RNA sequencing–derived OTTA-SPOT scores reached reproducible results in cases of high-grade serous ovarian cancer in Black patients, the cases in White patients were more comparable to the original findings. “These results highlight the need for the representation of diverse populations in ovarian cancer research to ensure that prognostic signatures will be beneficial to all patients,” the authors added.
Disclosure: The study authors reported no conflicts of interest.
