TY - JOUR
T1 - Second-line chemotherapy in recurrent clear cell ovarian cancer
T2 - Results from the Multicenter Italian Trials in Ovarian cancer (MITO-9)
AU - Esposito, Francesca
AU - Cecere, Sabrina Chiara
AU - Magazzino, Francescapaola
AU - Katsaros, Dionyssios
AU - Ottaiano, Alessandro
AU - Gadducci, Angiolo
AU - Pisano, Carmela
AU - Scalone, Simona
AU - Rabaiotti, Emanuela
AU - Salutari, Vanda
AU - Cormio, Gennaro
AU - Canuto, Emilie Marion
AU - Greggi, Stefano
AU - Savarese, Antonella
AU - Marinaccio, Marco
AU - Scollo, Paolo
AU - Santeufemia, Davide Adriano
AU - Sacco, Cosimo
AU - Facchini, Gaetano
AU - Pignata, Sandro
PY - 2014
Y1 - 2014
N2 - Background and Aims: Ovarian clear cell carcinoma (CCC) has a poorer prognosis than other subtypes of ovarian cancer. In this study, we evaluated the responsiveness to second-line chemotherapy in recurrent ovarian CCC. Methods: The MITO-9 project investigated a cohort of patients observed between 1991 and 2007 in 20 centers. We identified 72 out of 240 patients with recurrent disease (28% stage I-II and 72% stage III-IV at diagnosis). Results: In 56% of patients, the clear cell histology was pure. Twenty-five patients were platinum-resistant, 18 were platinum-sensitive with a platinum-free interval (PFI) of 6-12 months, and 29 had a PFI >12 months. Upon recurrence, 47% of patients were treated with platinum chemotherapy according to the PFI. The overall response rate (RR) to platinum was 80%, with 55, 100, and 80% RR in patients with PFI of 6-12, >12, and >24 months. The RR to nonplatinum agents in resistant patients was 33%. Among the nonplatinum agents used in primary and secondary resistant cases, gemcitabine, administered in 12 cases, had a higher activity (RR = 66%) compared to topotecan or liposomal doxorubicin (n = 31; RR = 33 and 10%, respectively). Conclusions: This study showed that the treatment of recurrent ovarian CCC should be based on the PFI as in the other subtypes. Data in platinum-resistant patients suggest gemcitabine as the drug with the highest activity. We recommend that gemcitabine be studied prospectively in a phase 2 trial.
AB - Background and Aims: Ovarian clear cell carcinoma (CCC) has a poorer prognosis than other subtypes of ovarian cancer. In this study, we evaluated the responsiveness to second-line chemotherapy in recurrent ovarian CCC. Methods: The MITO-9 project investigated a cohort of patients observed between 1991 and 2007 in 20 centers. We identified 72 out of 240 patients with recurrent disease (28% stage I-II and 72% stage III-IV at diagnosis). Results: In 56% of patients, the clear cell histology was pure. Twenty-five patients were platinum-resistant, 18 were platinum-sensitive with a platinum-free interval (PFI) of 6-12 months, and 29 had a PFI >12 months. Upon recurrence, 47% of patients were treated with platinum chemotherapy according to the PFI. The overall response rate (RR) to platinum was 80%, with 55, 100, and 80% RR in patients with PFI of 6-12, >12, and >24 months. The RR to nonplatinum agents in resistant patients was 33%. Among the nonplatinum agents used in primary and secondary resistant cases, gemcitabine, administered in 12 cases, had a higher activity (RR = 66%) compared to topotecan or liposomal doxorubicin (n = 31; RR = 33 and 10%, respectively). Conclusions: This study showed that the treatment of recurrent ovarian CCC should be based on the PFI as in the other subtypes. Data in platinum-resistant patients suggest gemcitabine as the drug with the highest activity. We recommend that gemcitabine be studied prospectively in a phase 2 trial.
KW - Clear cell
KW - Gemcitabine
KW - Ovarian carcinoma
KW - Second-line chemotherapy
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U2 - 10.1159/000358730
DO - 10.1159/000358730
M3 - Article
C2 - 24942520
AN - SCOPUS:84902301288
VL - 86
SP - 351
EP - 358
JO - Oncology
JF - Oncology
SN - 0030-2414
IS - 5-6
ER -