Department of Obstetrics and Gynecology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan.
Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
J Ovarian Res. 2020 Dec 8;13(1):143. doi: 10.1186/s13048-020-00751-3.
Patients with ovarian clear cell carcinoma (OCCC) have a poor prognosis because they show low sensitivity to platinum-based chemotherapy. New treatments for refractory OCCC are urgently needed.
We present a patient with refractory OCCC in whom conventional chemotherapy failed. Cachexia was induced by the disseminating recurrent tumors. Tumor tissue staining and genomic analysis revealed PD-L1 negativity, a low tumor burden, stable microsatellite instability, and two mutations in ARID1A. The patient was administered pembrolizumab combined with bevacizumab triweekly. Her serum CA-125 level decreased dramatically after the first cycle. A computerized tomography scan showed marked regression of the recurrent masses after 3 cycles, and the patient reached complete remission after 9 cycles. She showed good recovery from cachexia. We observed no marked side effects except for mild polyarthritis of the small joints.
The therapeutic effect of checkpoint inhibitors combined with angiogenesis inhibitors is very promising in our patient with OCCC. Further clinical trials of tumors including ARID1A mutations are warranted.
卵巢透明细胞癌（OCCC）患者预后较差，因为他们对铂类化疗的敏感性较低。迫切需要新的治疗方法来治疗难治性 OCCC。
我们报告了一例难治性 OCCC 患者，该患者对常规化疗无效。播散性复发性肿瘤导致恶病质。肿瘤组织染色和基因组分析显示 PD-L1 阴性、肿瘤负荷低、微卫星稳定和 ARID1A 中的两个突变。患者接受了帕博利珠单抗联合贝伐珠单抗每三周一次的治疗。第一周期后，患者的血清 CA-125 水平显著下降。计算机断层扫描显示复发性肿块在 3 个周期后明显消退，患者在 9 个周期后达到完全缓解。恶病质得到了很好的恢复。除了轻度小关节多发性关节炎外，我们没有观察到明显的副作用。
在我们的 OCCC 患者中，检查点抑制剂联合血管生成抑制剂的治疗效果非常有前景。需要进一步进行包括 ARID1A 突变在内的肿瘤的临床试验。
