Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary or peritoneum

Abstract

Objective. To evaluate the response of women with low-grade serous carcinoma of the ovary or peritoneum to platinum-based neoadjuvant chemotherapy. Methods. Using institutional databases, we identified 25 women with advanced low-grade serous carcinoma of the ovary or peritoneum treated with neoadjuvant platinum-based chemotherapy between 1989 and 2006. Demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan and Meier. Results. Median patient age at diagnosis was 45 years (range 29–81). The majority of patients ( n = 19, 76%) received a combination of a taxane and platinum drug. A median of six cycles of chemotherapy was administered (range 2–16). Of the 20 patients for whom pre- and post-neoadjuvant chemotherapy CA-125 levels were available, 50% had a > 50% reduction after neoadjuvant chemotherapy. However, radiographic survey of the 24 patients evaluable at the completion of neoadjuvant chemotherapy demonstrated one patient (4%) with a complete response, 21 (88%) with stable disease and 2 (8%) with progression following neoadjuvant chemotherapy. Median PFS and OS for all patients were 21.4 and 56.1 months, respectively. Conclusions. The low response rate to platinum-based neoadjuvant chemotherapy observed indicates that low-grade serous carcinoma is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials focused specifically on low-grade serous carcinoma are needed to make meaningful advances in the treatment of this disease.