Abstract
Introduction
Advanced clear cell adenocarcinoma of the ovary is a histologic type with an extremely poor prognosis. No reports have been published concerning useful drugs for salvage chemotherapy for this type of cancer. We performed salvage therapy with gemcitabine in a patient with multiple-drug- resistant, unresectable recurrent clear cell adenocarcinoma of the ovary and succeeded in stabilizing recurrent lesions and controlling carcinomatous peritonitis.
Case report
A 55-year-old woman was in Stage IIIc of clear cell adenocarcinoma of the ovary. She had recurrent tumors after primary cytoreductive surgery, which were unresectable and also resistant to paclitaxel, carboplatin, irinotecan, and oral etoposide. After three courses of fourth-line chemotherapy with gemcitabine for the treatment of carcinomatous peritonitis and hepatic and splenic metastatic lesions, serum CA-125 and the severity of ascites showed marked decreases, and its efficacy for the hepatic and splenic metastatic lesions was classified as 5-month stable disease. The toxicity of this drug was in the acceptable range.
Conclusion
Gemcitabine is also useful for heavily pretreated clear cell adenocarcinoma of the ovary. It is necessary to consider the use of drugs without cross resistance to platinum and taxanes in the selection of drugs for this cancer.
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References
Lund B, Hansen OP, Theilade K, Hansen M, Neijt JP (1994) Phase II study of gemcitabine (2’,2’- difluorodeoxycytidine) in previously treated ovarian cancer patients. J Natl Cancer Inst 86:1530–1533
Shapiro JD, Millward MJ, Rischin D, Michael M, Walcher V, Francis PA, Toner GC (1996) Activity of gemcitabine in patients with advanced ovarian cancer: responses seen following platinum and paclitaxel. Gynecol Oncol 63:89–93
Friedlander M, Millward MJ, Bell D, Bugat R, Harnett P, Moreno JA, Campbell L, Varette C, Ripoche V, Kayitalire L (1998) A phase II study of gemcitabine in platinum pre-treated patients with advanced epithelial ovarian cancer. Ann Oncol 9:1343–1345
von Minckwitz G, Bauknecht T, Visseren-Grul CM, Neijt JP (1999) Phase II study of gemcitabine in ovarian cancer. Ann Oncol 10:853–855
Silver DF, Piver MS (1999) Gemcitabine salvage chemotherapy for patients with gynecologic malignancies of the ovary, fallopian tube, and peritoneum. Am J Clin Oncol 22:450–452
Bilgin T, Ozalp S, Yalcin OT, Zorlu G, Vardar MA, Ozerkan K (2003) Efficacy of gemcitabine in heavily pretreated advanced ovarian cancer patients. Eur J Gynaecol Oncol 24:169–170
Markman M, Webster K, Zanotti K, Kulp B, Peterson G, Belinson J (2003) Phase 2 trial of single-agent gemcitabine in platinum–paclitaxel refractory ovarian cancer. Gynecol Oncol 90:593–596
Piura B, Rabinovich A (2004) Gemcitabine in heavily pretreated patients with recurrent ovarian, peritoneal and fallopian tube carcinoma. Eur J Gynaecol Oncol 25:449–452
Piura B (2005) Long-term disease-free survival effected by gemcitabine in a heavily pretreated patient with recurrent ovarian carcinoma. Arch Gynecol Obstet 271:182–3
Safra T, Ron I, Boaz M, Brenner J, Grisaru D, Inbar M, Hayat H, Menczer J, Golan A, Levy T (2006) Heavily pretreated ovarian cancer patients treated by single-agent gemcitabine. A retrospective outcome comparison between platinum-sensitive and platinum-resistant patients. Acta Oncol 45:463–468
Goff BA, Sainz de la Cuesta R, Muntz HG, Fleischhacker D, Ek M, Rice LW, Nikrui N, Tamimi HK, Cain JM, Greer BE, Fuller AF Jr (1996) Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol Oncol 60:412–417
Pectasides D, Fountzilas G, Aravantinos G, Kalofonos C, Efstathiou H, Farmakis D, Skarlos D, Pavlidis N, Economopoulos T, Dimopoulos MA (2006) Advanced stage clear-cell epithelial ovarian cancer: the Hellenic cooperative oncology group experience. Gynecol Oncol 102:285–291
Sugiyama T, Kamura T, Kigawa J, Terakawa N, Kikuchi Y, Kita T, Suzuki M, Sato I, Taguchi K (2000) Clinical characteristics of clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy. Cancer 88:2584–2589
Pather S, Quinn MA (2005) Clear cell cancer of the ovary-is it chemosensitive? Int J Gynecol Cancer 15:432–437
Fujimura M, Hidaka T, Kataoka K, Yamakawa Y, Akada S, Teranishi A, Saito S (2001) Absence of estrogen receptor-alpha expression in human ovarian clear cell adenocarcinoma compared with ovarian serous, endometrioid, and mucinous adenocarcinoma. Am J Surg Pathol 25:667–672
Schwartz DR, Kardia SL, Shedden KA, Kuick R, Michailidis G, Taylor JM, Misek DE, Wu R, Zhai Y, Darrah DM, Reed H, Ellenson LH, Giordano TJ, Fearon ER, Hanash SM, Cho KR (2002) Gene expression in ovarian cancer reflects both morphology and biological behavior, distinguishing clear cell from other poor-prognosis ovarian carcinomas. Cancer Res 62:4722–4729
Tsuchiya A, Sakamoto M, Yasuda J, Chuma M, Ohta T, Ohki M, Yasugi T, Taketani Y, Hirohashi S (2003) Expression profiling in ovarian clear cell carcinoma: identification of hepatocyte nuclear factor-1 beta as a molecular marker and a possible molecular target for therapy of ovarian clear cell carcinoma. Am J Pathol 163:2503–2512
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An erratum to this article can be found at http://dx.doi.org/10.1007/s00404-008-0863-5
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Komiyama, S., Nakamura, M., Murakami, I. et al. A heavily pretreated patient with recurrent clear cell adenocarcinoma of the ovary in whom carcinomatous peritonitis was controlled successfully by salvage therapy with gemcitabine. Arch Gynecol Obstet 278, 565–568 (2008). https://doi.org/10.1007/s00404-007-0396-3
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DOI: https://doi.org/10.1007/s00404-007-0396-3