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Erschienen in: International Journal of Clinical Oncology 5/2011

01.10.2011 | Case Report

Weekly administration of temsirolimus for heavily pretreated patients with clear cell carcinoma of the ovary: a report of six cases

verfasst von: Masashi Takano, Yoshihiro Kikuchi, Kazuya Kudoh, Tomoko Goto, Kenichi Furuya, Ryoko Kikuchi, Tsunekazu Kita, Keiichi Fujiwara, Tanri Shiozawa, Daisuke Aoki

Erschienen in: International Journal of Clinical Oncology | Ausgabe 5/2011

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Abstract

Clear cell carcinoma (CCC) of the ovary is well-known to be chemotherapy resistant compared with other histologic subtypes. An inhibitor against the mammalian target of rapamycin, temsirolimus (TEM) has been reported to be effective in renal CCC. Therefore, we investigated the effects of TEM in patients with CCC of the ovary. Six patients with CCC of the ovary who had been heavily pretreated by more than 4 regimens were given TEM: the cycle consisted of weekly TEM (10 mg/m2) for 3 weeks followed by 1 week off. The treatment was continued until development of either progressive disease, or unmanageable adverse effects. Response evaluation was based upon the Response Evaluation Criteria in Solid Tumors version 1.0. Adverse effects were analyzed according to Common Terminology Criteria for Adverse Events version 3.0. The median cycle of weekly TEM was 3 (range 2–14). Among five cases in which responses could be evaluated, partial response was observed in one case (20%) and stabilized disease was seen in another case (20%). There were no toxicities greater than grade 3, and no case developed severe toxicity requiring discontinuation of weekly TEM. The patient who showed a partial response obtained a progression-free period of 14 months. In conclusion, weekly TEM shows a potential therapeutic benefit for patients with CCC of the ovary. Further studies including a translational approach are needed to select candidates for whom TEM therapy would be beneficial.
Literatur
1.
Zurück zum Zitat Goff BA, Sainz de la Cuesta R, Muntz HG et al (1996) Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol Oncol 60:412–417PubMedCrossRef Goff BA, Sainz de la Cuesta R, Muntz HG et al (1996) Clear cell carcinoma of the ovary: a distinct histologic type with poor prognosis and resistance to platinum-based chemotherapy in stage III disease. Gynecol Oncol 60:412–417PubMedCrossRef
2.
Zurück zum Zitat Recio FO, Piver MS, Hempling RE et al (1996) Lack of improved survival plus increase in thromboembolic complications in patients with clear cell carcinoma of the ovary treated with platinum versus nonplatinum-based chemotherapy. Cancer 78:2157–2163PubMedCrossRef Recio FO, Piver MS, Hempling RE et al (1996) Lack of improved survival plus increase in thromboembolic complications in patients with clear cell carcinoma of the ovary treated with platinum versus nonplatinum-based chemotherapy. Cancer 78:2157–2163PubMedCrossRef
3.
Zurück zum Zitat Sugiyama T, Kamura T, Kigawa J et al (2000) Clinical characteristics of clear cell carcinoma of the ovary. Cancer 88:2584–2589PubMedCrossRef Sugiyama T, Kamura T, Kigawa J et al (2000) Clinical characteristics of clear cell carcinoma of the ovary. Cancer 88:2584–2589PubMedCrossRef
4.
Zurück zum Zitat Pectasides D, Fountzilas G, Aravantinos G et al (2006) Advanced stage clear-cell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience. Gynecol Oncol 102:285–291PubMedCrossRef Pectasides D, Fountzilas G, Aravantinos G et al (2006) Advanced stage clear-cell epithelial ovarian cancer: the Hellenic Cooperative Oncology Group experience. Gynecol Oncol 102:285–291PubMedCrossRef
5.
Zurück zum Zitat Enomoto T, Kuragaki C, Yamasaki M et al (2003) Is clear cell carcinoma and mucinous carcinoma of the ovary sensitive to combination chemotherapy with paclitaxel and carboplatin? Proc Am Soc Clin Oncol 22:abstr 1797 Enomoto T, Kuragaki C, Yamasaki M et al (2003) Is clear cell carcinoma and mucinous carcinoma of the ovary sensitive to combination chemotherapy with paclitaxel and carboplatin? Proc Am Soc Clin Oncol 22:abstr 1797
6.
Zurück zum Zitat Ho CM, Huang YJ, Chen TC et al (2004) Pure-type clear cell carcinoma of the ovary as a distinct histological type and improved survival in patients treated with paclitaxel-platinum-based chemotherapy in pure-type advanced disease. Gynecol Oncol 94:197–203PubMedCrossRef Ho CM, Huang YJ, Chen TC et al (2004) Pure-type clear cell carcinoma of the ovary as a distinct histological type and improved survival in patients treated with paclitaxel-platinum-based chemotherapy in pure-type advanced disease. Gynecol Oncol 94:197–203PubMedCrossRef
7.
Zurück zum Zitat Takano M, Sugiyama T, Yaegashi N et al (2008) Low response rate of second-line chemotherapy for recurrent or refractory clear cell carcinoma of the ovary: a retrospective Japan Clear Cell Carcinoma Study. Int J Gynecol Cancer 18:937–942PubMedCrossRef Takano M, Sugiyama T, Yaegashi N et al (2008) Low response rate of second-line chemotherapy for recurrent or refractory clear cell carcinoma of the ovary: a retrospective Japan Clear Cell Carcinoma Study. Int J Gynecol Cancer 18:937–942PubMedCrossRef
8.
Zurück zum Zitat Hudes G, Carducci M, Tomczak P et al (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356:2271–2281PubMedCrossRef Hudes G, Carducci M, Tomczak P et al (2007) Temsirolimus, interferon alfa, or both for advanced renal-cell carcinoma. N Engl J Med 356:2271–2281PubMedCrossRef
9.
Zurück zum Zitat Bellmunt J, Szczylik C, Feingold J et al (2008) Temsirolimus safety profile and management of toxic effects in patients with advanced renal cell carcinoma and poor prognostic features. Ann Oncol 19:1387–1392PubMedCrossRef Bellmunt J, Szczylik C, Feingold J et al (2008) Temsirolimus safety profile and management of toxic effects in patients with advanced renal cell carcinoma and poor prognostic features. Ann Oncol 19:1387–1392PubMedCrossRef
10.
Zurück zum Zitat Malizzia LJ, Hsu A (2008) Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal cell carcinoma. Clin J Oncol Nurs 12:639–646PubMedCrossRef Malizzia LJ, Hsu A (2008) Temsirolimus, an mTOR inhibitor for treatment of patients with advanced renal cell carcinoma. Clin J Oncol Nurs 12:639–646PubMedCrossRef
11.
Zurück zum Zitat Lee S, Garner EI, Welch WR et al (2007) Over-expression of hypoxia-inducible factor 1 alpha in ovarian clear cell carcinoma. Gynecol Oncol 106:311–317PubMedCrossRef Lee S, Garner EI, Welch WR et al (2007) Over-expression of hypoxia-inducible factor 1 alpha in ovarian clear cell carcinoma. Gynecol Oncol 106:311–317PubMedCrossRef
12.
Zurück zum Zitat Miyazawa M, Yasuda M, Fujita M et al (2009) Therapeutic strategy targeting the mTOR-HIF-1alpha-VEGF pathway in ovarian clear cell adenocarcinoma. Pathol Int 59:19–27PubMedCrossRef Miyazawa M, Yasuda M, Fujita M et al (2009) Therapeutic strategy targeting the mTOR-HIF-1alpha-VEGF pathway in ovarian clear cell adenocarcinoma. Pathol Int 59:19–27PubMedCrossRef
13.
Zurück zum Zitat Mabuchi S, Kawase C, Altomare DA et al (2009) mTOR is a promising therapeutic target both in cisplatin-sensitive and cisplatin-resistant clear cell carcinoma of the ovary. Clin Cancer Res 15:5404–5413PubMedCrossRef Mabuchi S, Kawase C, Altomare DA et al (2009) mTOR is a promising therapeutic target both in cisplatin-sensitive and cisplatin-resistant clear cell carcinoma of the ovary. Clin Cancer Res 15:5404–5413PubMedCrossRef
14.
Zurück zum Zitat Rustin GJ (2003) Use of CA-125 to assess response to new agents in ovarian cancer trials. J Clin Oncol 21(10 Suppl):187s–193sPubMedCrossRef Rustin GJ (2003) Use of CA-125 to assess response to new agents in ovarian cancer trials. J Clin Oncol 21(10 Suppl):187s–193sPubMedCrossRef
15.
Zurück zum Zitat Takano M, Kikuchi Y, Yaegashi N et al (2006) Clear cell carcinoma of the ovary: a retrospective multicentre experience of 254 patients with complete surgical staging. Br J Cancer 94:1369–1374PubMedCrossRef Takano M, Kikuchi Y, Yaegashi N et al (2006) Clear cell carcinoma of the ovary: a retrospective multicentre experience of 254 patients with complete surgical staging. Br J Cancer 94:1369–1374PubMedCrossRef
16.
Zurück zum Zitat Kuo KT, Guan B, Feng Y et al (2009) Analysis of DNA copy number alterations in ovarian serous tumors identifies new molecular genetic changes in low-grade and high-grade carcinomas. Cancer Res 69:4036–4042PubMedCrossRef Kuo KT, Guan B, Feng Y et al (2009) Analysis of DNA copy number alterations in ovarian serous tumors identifies new molecular genetic changes in low-grade and high-grade carcinomas. Cancer Res 69:4036–4042PubMedCrossRef
17.
Zurück zum Zitat Osada R, Horiuchi A, Kikuchi N et al (2007) Expression of hypoxia-inducible factor 1alpha, hypoxia-inducible factor 2alpha, and von Hippel-Lindau protein in epithelial ovarian neoplasms and allelic loss of von Hippel-Lindau gene: nuclear expression of hypoxia-inducible factor 1alpha is an independent prognostic factor in ovarian carcinoma. Hum Pathol 38:1310–1320PubMedCrossRef Osada R, Horiuchi A, Kikuchi N et al (2007) Expression of hypoxia-inducible factor 1alpha, hypoxia-inducible factor 2alpha, and von Hippel-Lindau protein in epithelial ovarian neoplasms and allelic loss of von Hippel-Lindau gene: nuclear expression of hypoxia-inducible factor 1alpha is an independent prognostic factor in ovarian carcinoma. Hum Pathol 38:1310–1320PubMedCrossRef
18.
19.
Zurück zum Zitat Hudson CC, Liu M, Chiang GG et al (2002) Regulation of hypoxia-inducible factor 1alpha expression and function by the mammalian target of rapamycin. Mol Cell Biol 22:7004–7014PubMedCrossRef Hudson CC, Liu M, Chiang GG et al (2002) Regulation of hypoxia-inducible factor 1alpha expression and function by the mammalian target of rapamycin. Mol Cell Biol 22:7004–7014PubMedCrossRef
20.
Zurück zum Zitat Harding MW (2003) Immunophilins, mTOR, and pharmacodynamic strategies for a targeted cancer therapy. Clin Cancer Res 9:2882–2886PubMed Harding MW (2003) Immunophilins, mTOR, and pharmacodynamic strategies for a targeted cancer therapy. Clin Cancer Res 9:2882–2886PubMed
21.
Zurück zum Zitat Del Bufalo D, Ciuffreda L, Trisciuoglio D et al (2006) Antiangiogenic potential of the mammalian target of rapamycin inhibitor temsirolimus. Cancer Res 66:5549–5554PubMedCrossRef Del Bufalo D, Ciuffreda L, Trisciuoglio D et al (2006) Antiangiogenic potential of the mammalian target of rapamycin inhibitor temsirolimus. Cancer Res 66:5549–5554PubMedCrossRef
22.
Zurück zum Zitat Raymond E, Alexandre J, Faivre S et al (2004) Safety and pharmacokinetics of escalated doses of weekly intravenous infusion of CCI-779, a novel mTOR inhibitor, in patients with cancer. J Clin Oncol 22:2336–2347PubMedCrossRef Raymond E, Alexandre J, Faivre S et al (2004) Safety and pharmacokinetics of escalated doses of weekly intravenous infusion of CCI-779, a novel mTOR inhibitor, in patients with cancer. J Clin Oncol 22:2336–2347PubMedCrossRef
23.
Zurück zum Zitat Atkins MB, Hidalgo M, Stadler WM et al (2004) Randomized phase II study of multiple dose levels of CCI-779, a novel mammalian target of rapamycin kinase inhibitor, in patients with advanced refractory renal cell carcinoma. J Clin Oncol 22:909–918PubMedCrossRef Atkins MB, Hidalgo M, Stadler WM et al (2004) Randomized phase II study of multiple dose levels of CCI-779, a novel mammalian target of rapamycin kinase inhibitor, in patients with advanced refractory renal cell carcinoma. J Clin Oncol 22:909–918PubMedCrossRef
24.
Zurück zum Zitat Crotzer DR, Sun CC, Coleman RL et al (2007) Lack of effective systemic therapy for recurrent clear cell carcinoma of the ovary. Gynecol Oncol 105:404–408PubMedCrossRef Crotzer DR, Sun CC, Coleman RL et al (2007) Lack of effective systemic therapy for recurrent clear cell carcinoma of the ovary. Gynecol Oncol 105:404–408PubMedCrossRef
25.
Zurück zum Zitat Utsunomiya H, Akahira J, Tanno S et al (2006) Paclitaxel–platinum combination chemotherapy for advanced or recurrent ovarian clear cell adenocarcinoma: a multicenter trial. Int J Gynecol Cancer 16:52–56PubMedCrossRef Utsunomiya H, Akahira J, Tanno S et al (2006) Paclitaxel–platinum combination chemotherapy for advanced or recurrent ovarian clear cell adenocarcinoma: a multicenter trial. Int J Gynecol Cancer 16:52–56PubMedCrossRef
Metadaten
Titel
Weekly administration of temsirolimus for heavily pretreated patients with clear cell carcinoma of the ovary: a report of six cases
verfasst von
Masashi Takano
Yoshihiro Kikuchi
Kazuya Kudoh
Tomoko Goto
Kenichi Furuya
Ryoko Kikuchi
Tsunekazu Kita
Keiichi Fujiwara
Tanri Shiozawa
Daisuke Aoki
Publikationsdatum
01.10.2011
Verlag
Springer Japan
Erschienen in
International Journal of Clinical Oncology / Ausgabe 5/2011
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-010-0177-z

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