Neil Alexander J, Muto Michael G, Kolin David L, Konstantinopoulos Panagiotis A
Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Division of Gynecologic Oncology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA, USA.
Gynecol Oncol Rep. 2023 Jul 7;48:101237. doi: 10.1016/j.gore.2023.101237. eCollection 2023 Aug.
Patients with advanced stage or recurrent mucinous ovarian carcinoma exhibit poor response to standard platinum- and taxane-based chemotherapy and poor prognosis. We report a 29-year-old patient with recurrent -amplified mucinous ovarian carcinoma (with expansile growth pattern at initial diagnosis and previously treated with adjuvant capecitabine/oxaliplatin) who underwent optimal secondary cytoreduction followed by 6 cycles of carboplatin/paclitaxel/trastuzumab and 1-year maintenance trastuzumab. This patient remains without radiologic or biochemical evidence of disease for more than 3 years after secondary cytoreduction. This case supports routine assessment of HER2 status in patients with advanced or recurrent mucinous ovarian carcinoma and highlights the potential of HER2-targeted therapy with trastuzumab in combination with standard carboplatin and paclitaxel in this disease. This case also raises the possibility that expansile mucinous ovarian carcinomas with amplification and p53 mutant immunohistochemical staining pattern (as this patient had) may be associated with a more aggressive behavior and higher risk of relapse.
晚期或复发性黏液性卵巢癌患者对基于铂类和紫杉烷的标准化疗反应不佳,预后较差。我们报告了一名29岁的复发性扩增性黏液性卵巢癌患者(初诊时呈膨胀性生长模式,曾接受辅助性卡培他滨/奥沙利铂治疗),该患者接受了最佳的二次肿瘤细胞减灭术,随后进行了6个周期的卡铂/紫杉醇/曲妥珠单抗治疗以及为期1年的曲妥珠单抗维持治疗。二次肿瘤细胞减灭术后3年多来,该患者一直没有疾病的影像学或生化证据。该病例支持对晚期或复发性黏液性卵巢癌患者进行HER2状态的常规评估,并突出了曲妥珠单抗靶向治疗联合标准卡铂和紫杉醇在该疾病中的潜力。该病例还提出了一种可能性,即具有扩增和p53突变免疫组化染色模式的膨胀性黏液性卵巢癌(该患者即如此)可能与更具侵袭性的行为和更高的复发风险相关。