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Background: Olaparib has significantly improved outcome and patient-centered endpoints in BRCA1/2-mutated patients with recurrent platinum-sensitive ovarian cancer (PSOC). Specific information on efficacy and safety of olaparib for older patients appears of special interest. Methods: 295 patients from the SOLO2 trial randomly assigned to olaparib or placebo were categorized according to age-cutoff at 65 years. Efficacy, tolerability, and quality of life (QoL) of olaparib relative to placebo within in each age group was analyzed. Results: Baseline characteristics were similar in patients ≥65 years (N = 62;21.0%) compared to patients

Background High-grade serous ovarian cancer (HGSOC) causes 80% of all ovarian cancer (OC) deaths. In this setting, the role of cancer stem-like cells (CSCs) is still unclear. In particular, the evolution of CSC biomarkers from primary (pOC) to recurrent (rOC) HGSOCs is unknown. Aim of this study was to investigate changes in CD133 and aldehyde dehydrogenase-1 (ALDH1) CSC biomarker expression in pOC and rOC HGSOCs. Methods Two-hundred and twenty-four pOC and rOC intrapatient paired tissue samples derived from 112 HGSOC patients were evaluated for CD133 and ALDH1 expression using immunohistochemistry (IHC); pOCs and rOCs were compared for CD133 and/or ALDH1 levels. Expression profiles were also correlated with patients' clinicopathological and survival data. Results Some 49.1% of the patient population (55/112) and 37.5% (42/112) pOCs were CD133+ and ALDH1+ respectively. CD133+ and ALDH1+ samples were detected in 33.9% (38/112) and 36.6% (41/112) rOCs. CD133/ALDH1 coexpression was observed in 23.2% (26/112) and 15.2% (17/112) of pOCs and rOCs respectively. Pairwise analysis showed a significant shift of CD133 staining from higher (pOCs) to lower expression levels (rOCs) (p < 0.0001). Furthermore, all CD133 + pOC patients were International Federation of Gynaecology and Obstetrics (FIGO)-stage III/IV (p < 0.0001) and had significantly worse progression-free interval (PFI) (p = 0.04) and overall survival (OS) (p = 0.02). On multivariate analysis, CD133/ALDH1 coexpression in pOCs was identified as independent prognostic factor for PFI (HR: 1.64; 95% CI: 1.03–2.60; p = 0.036) and OS (HR: 1.71; 95% CI: 1.01–2.88; p = 0.045). Analysis on 52 pts patients with known somatic BRCA status revealed that BRCA mutations did not influence CSC biomarker expression. Conclusions The study showed that CD133/ALDH1 expression impacts HGSOC patients' survival and first suggests that CSCs might undergo phenotypic change during the disease course similarly to non stem-like cancer cells, providing also a first evidence that there is no correlation between CSCs and BRCA status.

BACKGROUND Approximately one-third of all borderline ovarian tumours (BOT) are diagnosed in patients with child-bearing potential. Detailed information regarding their specific characteristics and prognostic factors is limited. METHODS Clinical parameters of BOT patients treated between 1998 and 2008 in 24 German centres were retrospectively investigated. Central pathology review and prospective follow-up were carried out. Patients

In February, 2010, a 45-year-old woman weighing 220 kg (body-mass index 68 kg/m2) was referred to our institution after a 3-month history of progressive abdominal distension without fever or night sweats or other complaints (appendix). Medical and family history was otherwise unremarkable, with her last gynaecological examination 2 years previously. Sonog raphy of the abdomen showed ascites but no other pathological changes. Repeated paracenteses drained 32 L of serous, exudative fl uid over 16 days. Cytology detected papillary formation of epithelial cells with psammoma bodies suggestive of a serous tumour of the ovaries. Sonography of the pelvis and abdomen and open fi eld MRI (patient’s weight and circumference precluded CT) showed large bilateral cystic pelvic tumours, abundant ascites, but no further pathological changes in the abdomen (fi gure A). Blood tests were normal except for a raised CA125 of 967 kU/L (normal range, 0–35). During an explorative laparotomy an additional 24 L of ascitic fl uid was drained. The pelvic tumours turned out to be enlarged ovaries, measuring 18 cm and 25 cm (appendix), without further macroscopic peritoneal tumour spread. Frozen section analysis suggested borderline ovarian tumour, and surgical staging with hysterectomy, bilateral salpingo-oophorectomy, omentectomy, appendectomy, and peritoneal biopsies was done. Defi nite histology showed adenofi broma of both ovaries with transition to serous borderline ovarian tumour, and non-invasive implants of the omentum. Unusually, extensive lymph atic vascular invasion was seen in the fallopian tube, the myometrium, and the wall of the appendix (fi gure B). These results were confi rmed by independent path ologists, and led to classifi cation of