Chemotherapy for ovarian clear cell adenocarcinoma with irinotecan hydrochloride and mitomycin C

Background No effective chemotherapy has been established for the treatment of ovarian clear cell adenocarcinomas. Based on the results of a sensitivity test in cultured cells, we investigated combination chemotherapy using irinotecan hydrochloride and mitomycin C. Methods Six patients with ovarian clear cell, adenocarcinoma and evaluative lesions were infused with irinotecan (140 mg/m²) intravenously over 4 hours and mitomycin C (7 mg/m²) was infused over 60 minutes directly into the pleuroperitoneal cavity or intravenously. One course comprised 3 doses of each agent at 2-week intervals and patients received at least 2 courses. Results A complete response was obtained in 1 patient (maintained for 12 months so far) and a partial response in 1 patient (maintained for 3 months and followed by relapse with peritoneal dissemination). In 3 of the 4 patients without tumor regression, carcinomatous effusions decreased or disappeared. Myelosuppression and gastrointestinal side effects were grade II or less in severity and thus were considered tolerable. Conclusion Because no chemotherapy regimens employing cisplatin are effective for ovarian clear cell adenocarcinomas, this regimen warrants further study.