Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary or peritoneum.
OBJECTIVE
To evaluate the response of women with low-grade serous carcinoma of the ovary or peritoneum to platinum-based neoadjuvant chemotherapy.


METHODS
Using institutional databases, we identified 25 women with advanced low-grade serous carcinoma of the ovary or peritoneum treated with neoadjuvant platinum-based chemotherapy between 1989 and 2006. Demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan and Meier.


RESULTS
Median patient age at diagnosis was 45 years (range 29-81). The majority of patients (n=19, 76%) received a combination of a taxane and platinum drug. A median of six cycles of chemotherapy was administered (range 2-16). Of the 20 patients for whom pre- and post-neoadjuvant chemotherapy CA-125 levels were available, 50% had a >50% reduction after neoadjuvant chemotherapy. However, radiographic survey of the 24 patients evaluable at the completion of neoadjuvant chemotherapy demonstrated one patient (4%) with a complete response, 21 (88%) with stable disease and 2 (8%) with progression following neoadjuvant chemotherapy. Median PFS and OS for all patients were 21.4 and 56.1 months, respectively.


CONCLUSIONS
The low response rate to platinum-based neoadjuvant chemotherapy observed indicates that low-grade serous carcinoma is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials focused specifically on low-grade serous carcinoma are needed to make meaningful advances in the treatment of this disease.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016208:Databases, Factual; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis; D013781:Texas; D016896:Treatment Outcome