Clinical features of long-term survivors of recurrent epithelial ovarian cancer

Iwase, Haruko; Takada, Toshio; Iitsuka, Chiaki; Nomura, Hidetaka; Abe, Akiko; Taniguchi, Takeo; Sakamoto, Kimihiko; Takizawa, Ken; Takeshima, Nobuhiro

doi:10.1007/s10147-014-0687-1

Cited by 17 publications

(12 citation statements)

References 23 publications

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“…On the other end, 3 patients were still alive at this long-term follow-up assessment, 1 of whom had no evidence of disease. Compared with known predictors for long-term outcomes after intraperitoneal RIT, this outcome was not foreseen (19,20). In the current study, 4 of 12 patients treated had a longer response time after a-radioimmunotherapy than after their previous regimen.…”

Section: Discussioncontrasting

confidence: 52%

Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

et al. 2019

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Eliminating microscopic residual disease with α-particle radiation is theoretically appealing. After extensive preclinical work with αparticle-emitting 211 At, we performed a phase I trial with intraperitoneal α-particle therapy in epithelial ovarian cancer using 211 At conjugated to MX35, the antigen-binding fragments-F(ab′) 2-of a mouse monoclonal antibody. We now present clinical outcome data and toxicity in a long-term follow-up with individual absorbed dose estimations. Methods: Twelve patients with relapsed epithelial ovarian cancer, achieving a second complete or nearly complete response with chemotherapy, received intraperitoneal treatment with escalating (20-215 MBq/L) activity concentrations of 211 At-MX35 F(ab′) 2. Results: The activity concentration was escalated to 215 MBq/L without any dose-limiting toxicities. Most toxicities were low-grade and likely related to the treatment procedure, not clearly linked to the α-particle irradiation, with no observed hematologic toxicity. One grade 3 fatigue and 1 grade 4 intestinal perforation during catheter implantation were observed. Four patients had a survival of more than 6 y, one of whom did not relapse. At progression, chemotherapy was given without signs of reduced tolerability. Overall median survival was 35 mo, with a 1-, 2-, 5-, and 10-y survival of 100%, 83%, 50%, and 25%, respectively. Calculations of the absorbed doses showed that a lower specific activity is associated with a lower single-cell dose, whereas a high specific activity may result in a lower central dose in microtumors. Individual differences in absorbed dose to possible microtumors were due to variations in administered activity and the specific activity. Conclusion: No apparent signs of radiation-induced toxicity or decreased tolerance to relapse therapy were observed. The dosimetric calculations show that further optimization is advisable to increase the efficacy and reduce possible long-term toxicity.

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Section: Discussioncontrasting

confidence: 52%

Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

et al. 2019

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“…Studies not reporting on long-term survival after ovarian cancer recurrence and studies reporting on women with borderline ovarian tumors or germ cell tumors of the ovary were excluded. After cross-searching the references of the 9 studies identified using this strategy, 8 additional studies were identified (17)(18)(19)(20)(21)(22)(23)(24). In summary, 17 studies were included in this review.…”

Section: Case Reportmentioning

confidence: 99%

“…Black bars representing 20 μm. ER, Estrogen receptor; PR, progesterone receptor.strategy in 4 studies(15,16,17,21). Firat et al used selective radiotherapy in the management of 28 women with recurrent ovarian cancer involving the vagina or rectum achieving long-term survival >5 years in 4 of them(15).…”

mentioning

confidence: 99%

What Characterizes Long-term Survivors of Recurrent Ovarian Cancer? Case Report and Review of the Literature

Hilal

Schultheis

Hartmann

et al. 2016

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“…Different factors may affect OS and PFS. Site of recurrence and number of nodules (31), sensitivity to chemotherapy and treatment for recurrence (32) have been shown to be associated with postrecurrence survival. Gallotta et al (33) reported that metastatic mesenteric lymph nodes were found in almost half of the cases with detectable mesenteric lymph nodes, which induced recurrences of ovarian cancer more frequently.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Systematic Lymphadenectomy in Patients With Optimally Debulked Advanced Ovarian Cancer: A Meta-Analysis

et al. 2020

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Background: The effect of systematic lymphadenectomy (SL) on survival in patients with optimally debulked advanced ovarian cancer remains unclear. We evaluated the therapeutic value of SL in advanced ovarian cancer patients who underwent primary optimal debulking surgery. Methods: A meta-analysis was carried out using articles retrieved from the PubMed, Embase, and Cochrane databases. Overall survival (OS) and progression-free survival (PFS) were compared between patients who underwent SL and those who underwent unsystematic lymphadenectomy (USL). Results: Seven studies that included 2,425 patients with advanced ovarian cancer were included in the meta-analysis. The overall analyses indicated significantly improved OS [hazard ratio (HR) = 0.64, 95% confidence interval (CI): 0.49-0.84, P < 0.01] but not PFS (HR = 0.89, 95% CI: 0.69-1.15, P = 0.38) in patients who underwent SL compared to those who underwent USL. Subgroup analyses based on study type, study quality, total numbers of patients, and International Federation of Gynecology and Obstetrics (FIGO) stage provided similar results. However, subgroup analysis of patients with no residual tumor revealed that SL was not associated with improved OS (HR = 0.81, 95% CI: 0.66-1.00, P = 0.05) or PFS (HR = 1.09, 95% CI: 0.91-1.30, P = 0.33). Conclusions: In patients with optimally debulked advanced ovarian cancer, SL may improve OS but not PFS. However, SL does not provide a survival advantage when macroscopically complete resection of all visible tumors is achieved.

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Clinical features of long-term survivors of recurrent epithelial ovarian cancer

Abstract: If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.

Cited by 17 publications

References 23 publications

Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

What Characterizes Long-term Survivors of Recurrent Ovarian Cancer? Case Report and Review of the Literature

Prognostic Significance of Systematic Lymphadenectomy in Patients With Optimally Debulked Advanced Ovarian Cancer: A Meta-Analysis

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Clinical features of long-term survivors of recurrent epithelial ovarian cancer

Abstract: If high sensitivity to platinum is maintained, patients with recurrent EOC may have prolonged survival following repeated platinum-based chemotherapy cycles. Moreover, their prognosis improves when chemotherapy is combined with secondary cytoreductive surgery and/or irradiation.

Cited by 17 publications

References 23 publications

Intraperitoneal α-Emitting Radioimmunotherapy with 211At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

Intraperitoneal α-Emitting Radioimmunotherapy with 211At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

What Characterizes Long-term Survivors of Recurrent Ovarian Cancer? Case Report and Review of the Literature

Prognostic Significance of Systematic Lymphadenectomy in Patients With Optimally Debulked Advanced Ovarian Cancer: A Meta-Analysis

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Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations

Intraperitoneal α-Emitting Radioimmunotherapy with ²¹¹At in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations