title: Impact of combination chemotherapy with itraconazole on survival for patients with recurrent or persistent ovarian clear cell carcinoma.
abstract: BACKGROUND
  Recurrent ovarian clear cell carcinoma (CCC) rarely responds to cytotoxic agents. Itraconazole is a potent inhibitor of the P-glycoprotein efflux pump, angiogenesis, and the Hedgehog pathway. We evaluated the efficacy of chemotherapy with itraconazole for CCC.
  
  
  METHODS
  Medical charts of patients with CCC who had received chemotherapy with itraconazole were retrospectively reviewed.
  
  
  RESULTS
  Among nine patients with CCC, five had a history of progression with paclitaxel and carboplatin, and none had received prior treatment with bevacizumab or other targeted therapy. Eight patients received docetaxel (35 mg/m(2), day 1) and carboplatin-based (area under the curve, 4 mg·min(-1)·mL(-1); day 1) chemotherapy with an oral itraconazole solution (400 mg, days -2 to 2), repeated every two weeks. The response rate, median progression-free survival and overall survival were 44% (95% confidence interval [(CI)=12-77%], 544 days (95% CI=82-544 days) and 1,047 days (95% CI=462-1332 days), respectively.
  
  
  CONCLUSIONS
  Chemotherapy with itraconazole is promising for patients with CCC.
authors.affiliation: Department of Obstetrics and Gynecology, Hyogo College of Medicine, Mukogawa 1-1, Nishinomiya, Hyogo, 663-8501, Japan. tsuba@hyo-med.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsubamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Sonoda
authors.forename: Masaaki
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Kayo
authors.initials: K
authors.lastname: Inoue
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D017964:Itraconazole
keywords: Itraconazole; chemotherapy; clear cell carcinoma; refractory disease; resistant disease