Multiple cases of squamous cell carcinoma of the tongue and oral cavity in patients treated with long-term pegylated liposomal doxorubicin (PLD) for ovarian cancer.

Abstract

5557 Background: Long-term maintenance therapy with PLD has been explored as a treatment for relapsed ovarian cancer (Andreopoulou et al. Ann Oncol 2007; 18:716-21). Our institution has monitored a cohort of patients on this therapy for side effects and secondary malignancies. Methods: We report on four patients receiving long-term PLD for advanced stage ovarian cancer who developed malignant and/or pre-malignant lesions of the tongue and/or oral cavity. Results: All four patients had received maintenance therapy with PLD for periods of at least three years. Three patients were diagnosed with squamous cell carcinoma (SCC) of the tongue and/or oral cavity, and one with sublingual mucosa high-grade dysplasia. Noteworthy was a patient with three separate SCCs of the oral cavity. Three of the four patients had deleterious BRCA mutations. None of the patients were former smokers. Immunohistochemical staining for p16 was negative in all of the SCC specimens. Conclusions: Secondary cancer of the oral cavity followed long-term PLD treatment of patients with recurrent ovarian cancer. These findings have implications on surveillance and preventative measures for this population. Patients with secondary oral SCC/dysplasia. Diagnosis Duration of treatment with PLD (months) Cumulative dose of PLD (mg/m2) Age at ovarian cancer diagnosis Age at oral cancer diagnosis HPV status Outcome T1N0M0 SCC of the tongue 96 1,800 65 76 - Died of cardiogenic shock. Sublingual dysplasia 132 2,320 55 67 - Alive; no evidence of malignancy at this time. T2N0 SCC of the tongue 32 2116 67 71 - Alive; no evidence of either malignancy at this time. Multi-focal oral SCC with three separate T1N0 lesions: left retromolar, anterior hard palate, and right buccal mucosa 80 3000 43 52 - Partial response to chemotherapy for oral SCC refractory to XRT. No evidence of ovarian cancer recurrence.