1. The role of neoadjuvant chemotherapy in the management of low-grade serous carcinoma of the ovary and peritoneum: Further evidence of relative chemoresistance
- Author
-
Kwong Kwok Wong, Shannon N. Westin, Alpa M. Nick, David M. Gershenson, Revathy B. Iyer, Lauren P. Cobb, Anil K. Sood, Charlotte C. Sun, Nicole D. Fleming, and Elvio G. Silva
- Subjects
Adult ,Bridged-Ring Compounds ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Organoplatinum Compounds ,Serous carcinoma ,medicine.medical_treatment ,Ovary ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Peritoneum ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,In patient ,Progression-free survival ,Peritoneal Neoplasms ,Response Evaluation Criteria in Solid Tumors ,Aged ,Aged, 80 and over ,Ovarian Neoplasms ,Chemotherapy ,business.industry ,Membrane Proteins ,Obstetrics and Gynecology ,Middle Aged ,Low grade serous carcinoma ,medicine.disease ,Neoadjuvant Therapy ,Progression-Free Survival ,Cystadenocarcinoma, Serous ,Ki-67 Antigen ,030104 developmental biology ,medicine.anatomical_structure ,Drug Resistance, Neoplasm ,CA-125 Antigen ,030220 oncology & carcinogenesis ,Female ,Taxoids ,business ,Ovarian cancer - Abstract
Low-grade serous carcinoma of the ovary/peritoneum (LGSC) is relatively chemoresistant in the adjuvant, neoadjuvant, and recurrent settings. We sought to expand our prior work and evaluate response rates of women with LGSC to neoadjuvant chemotherapy (NACT) compared to women with high-grade serous carcinoma of the ovary/peritoneum (HGSC).Thirty-six patients with LGSC who received NACT were matched to patients with HGSC. A single radiologist re-reviewed pre- and post-NACT imaging for response using RECIST 1.1. Pre- and post-NACT CA-125 values were compared using paired t-tests. Kaplan-Meier estimates of progression free survival (PFS) and overall survival (OS) were performed.All patients received neoadjuvant platinum-based regimens. LGSC patients received a median of 5 cycles (range 3-9), HGSC patients received a median of 4 cycles (range 3-9). Interval cytoreductive surgery was performed in 29/36 (81%) of LGSC and 32/36 (89%) HGSC patients. Complete cytoreduction was reported and achieved in 11/29 (38%) of LGSC patients and 24/32 (75%) of HGSC patients (p = 0.002). Median pre- and post-treatment CA-125 levels for LGSC patients were 295.5 U/mL and 144 U/mL (52% decrease) (p 0.001). The median pre- and post-treatment CA-125 levels for HGSC patients were 767.5 and 35.6 (96% decrease) (p 0.001). For LGSC patients, 4/36 (11%) had partial response (PR), 30/36 (83%) had stable disease (SD), and 2/36 (6%) had progressive disease (PD). In HGSC patients, 27/36 (75%) had PR, and 9/36 (25%) SD. Median PFS for LGSC patients was 18.5 months and median OS was 47.4 months.This study provides further evidence of relative chemoresistance of LGSC in patients treated with NACT.
- Published
- 2020