Low response rate of second-line chemotherapy for recurrent or refractory clear cell carcinoma of the ovary: a retrospective Japan Clear Cell Carcinoma Study.
Clear cell carcinoma (CCC) of the ovary has been recognized to show resistance to anticancer agents in the first-line chemotherapy. Our aim was to evaluate the effect of second-line chemotherapy in a retrospective study. A total of 75 patients diagnosed with CCC and treated between 1992 and 2002 in collaborating hospitals were reviewed. Criteria for the patients' enrollment were 1) diagnosis of pure-type CCC at the initial operation, 2) treatment after one systemic postoperative chemotherapy, 3) measurable recurrent or refractory tumor, 4) at least two cycles of second-line chemotherapy and assessable for the response, and 5) adequate clinical information. Regimens of first-line chemotherapy were conventional platinum-based therapy in 33 cases, paclitaxel plus platinum in 24 cases, irinotecan plus platinum in 9 cases, and irinotecan plus mitomycin C in 7 cases. Treatment-free periods were more than 6 months in 24 cases (group A) and less than 6 months in 51 cases (group B). In group A, response was observed in two cases (8%): one with conventional platinum therapy and another with irinotecan plus platinum. In group B, three cases (6%) responded: two with platinum plus etoposide and one case with irinotecan plus platinum. Median overall survival was 16 months in group A and 7 months in group B (P = 0.04). These findings suggest recurrent or resistant CCC is extremely chemoresistant, and there is only small benefit of long treatment-free period in CCC patients. Another strategy including molecular-targeting therapy is warranted for the treatment of recurrent or refractory CCC.
Takano
M
M
Department of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Sugiyama
T
T
Yaegashi
N
N
Sakuma
M
M
Suzuki
M
M
Saga
Y
Y
Kuzuya
K
K
Kigawa
J
J
Shimada
M
M
Tsuda
H
H
Moriya
T
T
Yoshizaki
A
A
Kita
T
T
Kikuchi
Y
Y
D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate; D013997:Time Factors
D000970:Antineoplastic Agents