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Rare Ovarian Cancer More Difficult to Treat

CancerWise - May 2008

A rare type of ovarian cancer, recurrent low-grade serous carcinoma, does not respond well to chemotherapy and is more difficult to treat than more common high-grade ovarian cancers, study results say.

The research, conducted at M. D. Anderson, was reported in March during the Society of Gynecologic Oncologists Annual Meeting on Women's Cancers.

Significance of research

This retrospective study is the first to look at how low-grade recurrent ovarian tumors respond to chemotherapy.

The results support a growing body of research that shows low-grade ovarian tumors behave differently than other ovarian cancer tumors and are more resistant to chemotherapy than other ovarian cancers, says lead author David Gershenson, M.D., professor and chair of M. D. Anderson’s Department of Gynecologic Oncology.

Low-grade serous carcinoma represents about 10% of serous ovarian cancers.

Background

Because low-grade serous ovarian cancer is so resistant to treatment, a standard of care does not exist.

In addition, there is no universal grading system for the cancer. Consequently, there are variations in classifying and treating the disease.

Research methods

Researchers searched patient databases to identify women treated for recurrent low-grade serous carcinoma of the ovary at M. D. Anderson from 1990 through 2007.

Primary results

The database search revealed 52 patients who had one or more of 98 different chemotherapy regimens including platinum-based chemotherapies in which patients were sensitive (more responsive) and resistant (unresponsive) to treatment.

The researchers found that the:

  • Overall response rate was 4%
  • Response rate in platinum-sensitive disease was 6%
  • Overall response rate in platinum-resistant disease was 2%

Of all the treatments, 62% stabilized the disease for a median of 22 weeks.

Additional results

Gershenson said these results compare unfavorably to treatment of more common ovarian cancers.

"It is unclear whether the high rate of stable disease is more reflective of tumor biology of low-grade serous carcinoma of the ovary or of the therapy regimen administered,” he says.

What’s next?

Since these tumors do not respond well to conventional chemotherapies, new agents to treat them must be identified and tested, Gershenson says.

Hormonal therapy, which has shown some activity against low-grade serous carcinoma, warrants further exploration, he says. M. D. Anderson plans a detailed analysis of its experience with hormonal therapy in the near future.

Recognizing the need for more research, the Gynecologic Oncology Group, a National Cancer Institute-funded cooperative group, recently established a rare tumor committee that has initiated a separate series of clinical trials for recurrent low-grade serous carcinoma, as well as for other rare ovarian cancers.

- Adapted by Dawn Dorsey from an M. D. Anderson news release

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CancerWise - May 2008


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