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Sunday, August 28, 2016

Genomic alterations in neuroendocrine cancers of the ovary (small cell carcinoma of the ovary)

Journal of Ovarian Research | Full Text


As we have previously reported, small cell carcinoma of the ovary (SCCO) is a rare, aggressive form of ovarian cancer associated with poor outcomes. In an effort to identify new treatment options, we utilized comprehensive genomic profiling to assess the potential for novel therapies in SCCO.

Neuroendocrine cancers of the ovary are rare malignancies. With no recurrent actionable mutations, treatment remains a challenge. Future clinical trials looking at standard of care chemotherapy using platinum based chemotherapeutics and comparing that to specific chemotherapy regimens based off of IHC mutations may prove to be of significance in treating this rare disease. Our study showed that all SCCO types showed high expression of TOP2A, therefore, trials comparing platinum based therapies to topoisomerase II inhibitors such as doxorubicin or etoposide in patients who have high expression of ERCC1, which is associated with platinum resistance, may lead to a change in our approach to this subset of diseases. Also, there is potential for clinical trials comparing standard chemotherapy to PD1/PDL1 inhibition in SCCO as our subset of SCCO patients showed increased expression of PD1 and PDL1. Novel treatment options can be used on a case-by-case basis depending on the genomic profile. Prospective studies need to be conducted for better results, but given the rarity of this disease, that may prove to be difficult.


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