Targeted therapy and immunotherapy for platinum-refractory advanced ovarian adenosquamous carcinoma: a case report

Li, Anji; Sun, Shuai; Song, Tao; Li, Xi; Cheng, Wen; Yao, Ruipin; Zhang, Danying; Zhang, Cai; Zhang, Jie; Zhai, Dongxia; Yu, Chaoqin

doi:10.2147/ott.s162985

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Combined with the results of this study, we could infer that although CENO patients were mostly diagnosed with stage I/II, their prognosis was not optimistic. In 2018, Yu et al reported a 38-year-old woman diagnosed with stage II CENO with elevated preoperative CA125 levels [ 26 ]. This patient discontinued the drug regimen after receiving several cycles of postoperative chemotherapy and antiangiogenic therapy with no effect and significant side effects.…”

Section: Discussionmentioning

confidence: 99%

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Ding

Liu

et al. 2022

J Ovarian Res

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Background Complex epithelial neoplasms of the ovary (CENO), an uncommon pathological histotype in ovarian cancer, comprises adenosquamous carcinoma and adenocarcinoma with metaplasia. Owing to the rarity of relevant reports, there are currently no statistics on outcomes based on large samples. Meanwhile high-grade serous ovarian cancer (HGSOC) is the most common histotype in ovarian cancer which has a recognized first-line treatment regimen and poor prognosis. Thus, we aimed to determine the characteristics, prognosis, and independent predictors of survival for CENO, compare them with those of HGSOC and construct prognostic predictive models and nomograms. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to determine patients diagnosed with CENO or HGSOC from 2000 to 2017. Clinical, demographic, and treatment characteristics were compared between these groups. Propensity score matching, Cox risk regression analysis, Kaplan–Meier survival curves, and the Least Absolute Shrinkage and Selection Operator regression analysis were employed for analyzing the data. Results Here, 31,567 patients with HGSOC and 216 patients with CENO between 2000 and 2017 in the SEER database were enrolled. Age < 57 years, unmarried, and early-stage diseases were more common in patients with CENO than in those with HGSOC. Women with CENO were less likely to receive adjuvant chemotherapy (65.7% vs. 79.4%) but more likely to receive radiotherapy (6.0% vs. 0.8%; both p < 0.001) than those with HGSOC. Year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors for overall and cancer-specific survival in CENO. Overall survival rates were significantly lower for CENO than for more malignant HGSOC. Conclusions In summary, CENO was rare in ovarian cancer, while the year of diagnosis, surgery status, number of primary tumors, grade, and FIGO stage were independent prognostic factors. Compared with other common malignant ovarian tumors, CENO had a poor prognosis. Prognostic predictive models and nomograms had been determined to predict the individual survival rates of patients with CENO. These methods could improve evaluations of survival and therapeutic decisions for patients.

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Section: Discussionmentioning

confidence: 99%

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Ding

Liu

et al. 2022

J Ovarian Res

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“…[ 20 ] Recently, 2 case reports have demonstrated that pembrolizumab monotherapy or combination therapy is effective to control the progress of disease including metastatic ovarian carcinosarcoma and ovarian adenosquamous carcinoma. [ 21 , 22 ] Additionally, some clinical trials have shown that pembrolizumab therapy is effective for other gynecologic cancers, including cervical and endometrial cancer. [ 23 , 24 ] In May 2017, the FDA has approved pembrolizumab for patients with unresectable or MSI-H or mismatch repair gene defects (dMMR) solid tumors that progressed following prior treatment.…”

Section: Discussionmentioning

confidence: 99%

Responses of metastatic primary fallopian tube carcinoma to pembrolizumab and nab-paclitaxel

Jiang

Chen²,

Zhu³

et al. 2020

Medicine

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Rationale: Primary fallopian tube carcinoma (PFTC) is an extremely rare but invasive malignancy with a dismal prognosis. Very few data exist on the salvage treatment for patients with PFTC. Here we report a case showing an impressive response to immunotherapy combined with chemotherapy, which have never been reported before on patients with metastatic PFTC. Patient concerns: A 42-year-old woman, who was diagnosed with PFTC in 2010, had been failed of multiple systemic therapies and antiangiogenic therapy because of the disease recurrence and progression. Diagnosis: Metastatic primary fallopian tube carcinoma. Interventions: The patient underwent surgery in May 2010 and had multi-line chemotherapies plus an anti-vascular endothelial growth factor (anti-VEGF) monoclonal antibody for about 9 years. Due to treatment failure the patient accepted the immunotherapy with the checkpoint inhibitor, pembrolizumab, combined with nab-paclitaxel from December 2018 to April 2019. Outcomes: The patient showed a complete response after 6 cycles , treatment. Thus far, the patient is taking pembrolizumab as maintenance and remains in good health. Lessons: Pembrolizumab combined with chemotherapy for treatment of PFTC may provide a positive antitumor effect in multiple metastatic lesions, but more clinical evidence is needed to confirm the efficacy and safety.

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“…A case report described a marked and long-lasting response in a patient with relapsed OC who received nivolumab and pazopanib. Interesting, one of the prior regimens this patient had received (and responded to) was a PARP inhibitor (olaparib) with nivolumab [ 104 ]. A phase I dose-escalation study was published investigating two combinations, durvalumab + cediranib and durvalumab + olaparib in patients with gynecologic cancers, including 19 with OC [ 105 ].…”

Section: Clinical Evidence For Combination Of Antiangiogenic Therapy mentioning

confidence: 99%

Are antiangiogenics a good ‘partner’ for immunotherapy in ovarian cancer?

et al. 2020

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Ovarian cancer (OC) is associated with poor survival because there are a limited number of effective therapies. Two processes key to OC progression, angiogenesis and immune evasion, act synergistically to promote tumor progression. Tumor-associated angiogenesis promotes immune evasion, and tumor-related immune responses in the peritoneal cavity and tumor microenvironment (TME) affect neovascular formation. Therefore, suppressing the angiogenic pathways could facilitate the arrival of immune effector cells and reduce the presence of myeloid cells involved in immune suppression. To date, clinical studies have shown significant benefits with antiangiogenic therapy as first-line therapy in OC, as well as in recurrent disease, and the vascular endothelial growth factor (VEGF) inhibitor bevacizumab is now an established therapy. Clinical data with immunomodulators in OC are more limited, but suggest that they could benefit some patients with recurrent disease. The preliminary results of two phase III trials have shown that the addition of immunomodulators to chemotherapy does not improve progression-free survival. For this reason, it could be interesting to look for synergistic effects between immunomodulators and other active drugs in OC. Since bevacizumab is approved for use in OC, and is tolerable when used in combination with immunotherapy in other indications, a number of clinical studies are underway to investigate the use of bevacizumab in combination with immunotherapeutic agents in OC. This strategy seeks to normalize the TME via the anti-VEGF actions of bevacizumab, while simultaneously stimulating the immune response via the immunotherapy. Results of these studies are awaited with interest.

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Targeted therapy and immunotherapy for platinum-refractory advanced ovarian adenosquamous carcinoma: a case report

Cited by 5 publications

References 29 publications

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Differences between complex epithelial neoplasms of the ovary and high-grade serous ovarian cancer: a retrospective observational cohort study

Responses of metastatic primary fallopian tube carcinoma to pembrolizumab and nab-paclitaxel

Are antiangiogenics a good ‘partner’ for immunotherapy in ovarian cancer?

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