Individualized chemotherapeutic regimen for each histological subtype of ovarian carcinoma

Ovarian carcinoma can be classified into the following distinct two groups in terms of chemosensitivity. The chemosensitive group includes serous, endometrioid, transitional cell carcinoma (TCC), and undifferentiated carcinoma, with a response rate to CDDP-based chemotherapy (CTX) being approximately 80 to 90%. Even within this chemosensitive group, the mode of the response to chemotherapy may vary by the histologic subtype or the grade of differentiation. The chemo-resistant group consists of mucinous and clear-cell adenocarcinoma (CCA), with a response rate to CDDP-based regimen being less than 5% or none. Especially, for pure CCA of the ovary, no one case has ever been reported to have shown an appreciable response to a CDDP-based regimen. As a result, advanced patients with mucinous carcinoma or CCA of the ovary not amenable to a complete surgery have a poor prognosis. The author developed a promising new regimen consisting of CPT-11 with mitomycin-C based both on in vitro and in vivo chemosensitivity tests. Thus, an individualized regimen may be required for both CDDP-sensitive and resistant diseases.