Intraperitoneal recombinant interferon gamma in ovarian cancer patients with residual disease at second-look laparotomy.

PURPOSE The purpose of this study was to evaluate the efficacy and tolerance of recombinant human interferon gamma (rIFN-gamma) as second-line treatment in patients with persistent disease at second-look laparotomy. PATIENTS AND METHODS One hundred eight patients with residual disease at second-look laparotomy were treated with rIFN-gamma (20 x 10(6) IU/m2) administered intraperitoneally (IP) twice a week for 3 to 4 months. In the absence of clinically assessable disease, response to rIFN-gamma was assessed with a third-look laparotomy. RESULTS Of 98 assessable patients, 31 (32%) achieved a surgically documented response, including 23 patients (23%) with a complete response (CR). The age and size of residual tumor were significant prognostic factors for the response to rIFN-gamma. A 41% CR rate was observed in 41 patients younger than 60 years and with residual tumor less than 2 cm. The probability of response was independent of previous response to first-line chemotherapy. The median duration of response was 20 months and the 3-year survival rate in responders was 62%. Response to rIFN-gamma was the most significant prognostic factor for survival of patients with residual disease. Adverse events included fever, flu-like syndrome, neutropenia, and liver enzyme disturbances. No significant peritoneal fibrosis was noted. CONCLUSION These results support the potential interest of IP rIFN-gamma as adjuvant treatment in ovarian cancer. Controlled prospective trials are required to determine its place in the therapeutic strategy of this malignancy.

Download Full-text

Evaluation of staging, cytoreduction and second-look operation of 119 ovarian cancer patients

Sao Paulo Medical Journal ◽

10.1590/s1516-31801997000500006 ◽

1997 ◽

Vol 115 (5) ◽

pp. 1542-1547

Author(s):

Eddie Fernando Candido Murta ◽

Jurandyr Moreira de Andrade ◽

Maurício Mesquita Sabino de Freitas ◽

Sérgio Bighetti

Keyword(s):

Ovarian Cancer ◽

Retrospective Study ◽

Medical Records ◽

Residual Disease ◽

School Of Medicine ◽

Second Look ◽

Gynecology And Obstetrics ◽

Data Source ◽

Level Of Significance ◽

Second Look Operation

OBJECTIVE:This study was conducted on patients with ovarian cancer in order to evaluate survival. DESIGN: A retrospective study of 119 cases of ovarian cancer from January 1977 to December 1992 with observation until 1993. LOCATION: Department of Gynecology and Obstetrics, Ribeirão Preto School of Medicine, São Paulo University. PARTICIPANTS: Of the 119 cases, 70 (58.8%) presented epithelial carcinomas and 21 (17.6%) tumors of the sexual girdle/stroma. DATA SOURCE: The data were obtained from the medical records of the patients. MEASUREMENT: Statistical analysis of survival time was based on the nonparametric Mann-Whitney test with the level of significance set at P < 0.05. RESULTS: The patients with a negative second look had a mean survival of 79.4 ± 48.5 months versus 24.2 ± 15.1 months for patients with a positive second look (P < 0.02). CONCLUSIONS: It is concluded that patients with a negative second look present a better prognosis compared to those with residual disease.

Download Full-text

Mechanism of interaction between cisplatin and human recombinant interferon gamma in human ovarian-cancer cell lines

International Journal of Cancer ◽

10.1002/ijc.2910610510 ◽

1995 ◽

Vol 61 (5) ◽

pp. 643-648 ◽

Cited By ~ 7

Author(s):

Alissar Nehmé ◽

Nicolas Albin ◽

Marie Josée Caliaro ◽

Sylvie Guichard ◽

Suzanne Jozan ◽

...

Keyword(s):

Ovarian Cancer ◽

Cell Lines ◽

Cancer Cell ◽

Interferon Gamma ◽

Ovarian Cancer Cell ◽

Human Ovarian Cancer ◽

Human Ovarian Cancer Cell ◽

Recombinant Interferon ◽

Ovarian Cancer Cell Lines ◽

Mechanism Of Interaction

Download Full-text

A randomized trial comparing cisplatin plus cyclophosphamide versus cisplatin, doxorubicin, and cyclophosphamide in advanced ovarian cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1986.4.6.965 ◽

1986 ◽

Vol 4 (6) ◽

pp. 965-971 ◽

Cited By ~ 108

Author(s):

P F Conte ◽

M Bruzzone ◽

S Chiara ◽

M R Sertoli ◽

M G Daga ◽

...

Keyword(s):

Ovarian Cancer ◽

Median Survival ◽

Stable Disease ◽

Residual Disease ◽

Performance Status ◽

Advanced Ovarian Cancer ◽

Progression Free Survival ◽

Complete Response ◽

Free Survival ◽

Second Look

After primary surgery, 125 patients with epithelial ovarian cancer (International Federation of Gynaecology and Obstetrics [FIGO] 1c + IIb + IIc = 22 patients, FIGO III = 82 patients, FIGO IV = 21 patients) were randomly allocated to receive PC (cisplatin 50 mg/m2 + cyclophosphamide 600 mg/m2 on day 1 every 28 days) (corrected) or PAC (PC + doxorubicin 45 mg/m2). After six cycles, patients clinically disease-free or with resectable residual disease were submitted to second-look surgery. After restaging, patients in surgical complete response (CR) stopped treatment while those responding partially (PR) received six more courses; patients whose disease progressed were excluded from the study. Among patients with measurable disease, the following clinical response rates were observed: PC = 20% CR, 34.3% PR, 14.3% stable disease, and 31.4% progression; PAC = 40.6% CR, 15.6% PR, 12.5% stable disease, and 31.3% progression. In the 75 patients submitted to second look, the results have been the following: PC = 39.5% CR, 36.8% PR, 7.9% stable disease, and 15.8% progression; PAC = 62.2% CR, 18.9% PR, 10.8% stable disease, and 8.1% progression. The difference in surgical complete response in favor of the PAC regimen is significant (P less than .05). Median survival and progression-free survival were 800 and 400 days, respectively, for PAC arm; median survival and progression-free survival were 680 and 380 days, respectively, for PC. These differences are not significant. Probability of survival was affected by FIGO stage, amount of residual disease, histology, performance status, and response at second look, while no influence was observed according to grade of tumor differentiation and age. Our results demonstrate the usefulness of doxorubicin in terms of surgical CR.

Download Full-text

Clinical Value of Radioimmunoscintigraphy in the follow-up of Ovarian Carcinoma: A Prospective Study

The International Journal of Biological Markers ◽

10.1177/172460089000500301 ◽

1990 ◽

Vol 5 (3) ◽

pp. 103-108 ◽

Cited By ~ 4

Author(s):

F. Crippa ◽

M. Presti ◽

A. Marini ◽

B. D'Onofrio ◽

G. Bolis ◽

...

Keyword(s):

Ovarian Cancer ◽

Ovarian Carcinoma ◽

Residual Tumor ◽

Clinical Value ◽

Second Look ◽

Tumor Persistence ◽

Upper Abdominal ◽

Abdominal Lesions ◽

A Prospective Study

Twenty-five patients treated with debulking surgery and chemotherapy for ovarian cancer were prospectively studied to evaluate the efficacy of radioimmunoscintigraphy (RIS) in detecting residual tumor before second-look surgery. RIS was performed with the monoclonal antibody OC125 F(ab')2 labelled with 1-131 without knowledge of clinical data and compared with subsequent surgical results. Second look showed tumor persistence in 12 patients, mostly characterized by small lesions. The overall diagnostic sensitivity of RIS was 50% and the specificity was 85%. In particular, RIS showed better sensitivity for pelvic tumor localizations than for abdominal sites (73% vs 33%); this was due to the inability of RIS to detect upper abdominal lesions. Therefore, our conclusion is that, at present, RIS cannot substitute surgical second-look in the management of ovarian cancer, however, considering that also ultrasonography, computer tomography and magnetic resonance are not always able to give definite diagnostic evidence in the follow-up of ovarian carcinoma, RIS could be added to these procedures to balance the limitations of each method. In this regard, the best application of RIS could be in the follow-up of patients with marker elevation without clinical evidence of disease, especially in the case of pelvic fibrosis or adhesions due to previous therapy, where the other non-invasive tools can give doubtful diagnostic results.

Download Full-text

The second-look operation improves survival in suboptimally debulked stage III ovarian cancer patients

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200501000-00004 ◽

2005 ◽

Vol 15 (1) ◽

pp. 19-25 ◽

Cited By ~ 3

Author(s):

J. Rahaman ◽

P. Dottino ◽

T. S. Jennings ◽

J. Holland ◽

C. J. Cohen

Keyword(s):

Ovarian Cancer ◽

Residual Disease ◽

Stage Iii ◽

Single Institution ◽

Primary Ovarian Cancer ◽

Primary Surgery ◽

Second Look ◽

Survival Difference ◽

Second Look Operation

In a single-institution retrospective cohort study, 230 patients were treated for stage III primary ovarian cancer and 175 became eligible for second-look operations by virtue of a complete clinical response after primary surgical cytoreduction and platinum-based combination chemotherapy. Of these, 109 underwent a second-look operation. Optimal primary cytoreduction was defined as residual disease ≤1 cm. Median follow-up was 68.3 months. Five-year survival for all the 230 stage III ovarian cancers was 43.4%. Among all eligible patients (n = 175), there was no survival difference (P = 0.67) in those having second look (57.3%, 5-year survival) versus no second look (48.7%). In those patients with optimal primary cytoreduction (n = 118), there was no survival advantage to second look (69% versus 61%, P = 0.7). However, in those with suboptimal primary cytoreduction (n = 47), 5-year survival was 36% in those having second look versus only 13% in those refusing second look (P < 0.05). Multivariate analysis identified second-look surgery as the only significant independent prognostic variable affecting survival (RR = 0.321, P < 0.04). Patients with suboptimal debulking at primary surgery for stage III ovarian cancer appear to achieve a survival benefit from second-look surgical procedures, presumably from the early identification and treatment of residual disease.

Download Full-text

Recombinant interleukin-2 continuous infusion in ovarian cancer patients with minimal residual disease at second-look

Cancer Treatment Reviews ◽

10.1016/0305-7372(89)90032-7 ◽

1989 ◽

Vol 16 ◽

pp. 123-127 ◽

Cited By ~ 4

Author(s):

P. Benedetti Panici ◽

G. Scambia ◽

S. Greggi ◽

P. Di Roberto ◽

G. Ragusa ◽

...

Keyword(s):

Ovarian Cancer ◽

Continuous Infusion ◽

Cancer Patients ◽

Minimal Residual Disease ◽

Residual Disease ◽

Interleukin 2 ◽

Second Look ◽

Recombinant Interleukin 2 ◽

Minimal Residual

Download Full-text

Adoptive Cell Immunotherapy for Epithelial Ovarian Cancer

10.1093/med/9780190248208.003.0005 ◽

2018 ◽

Author(s):

Samir A. Farghaly

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Residual Disease ◽

Adoptive Cell Therapy ◽

Human Leukocyte ◽

Progression Free Survival ◽

Tumor Infiltrating Lymphocytes ◽

Residual Tumor ◽

Disease Recurrence ◽

Platinum Based Chemotherapy

The standard management for epithelial ovarian cancer (EOC) is a combination of aggressive debulking surgery with residual tumor of less than 1 cm and platinum-based chemotherapy. However, a high percentage of patients experience disease recurrence. Extensive efforts to find new therapeutic options have been made, albeit cancer cells develop drug resistance and malignant progression occurs. Novel therapeutic strategies are needed to enhance progression-free survival and overall survival of patients with advanced EOC. Several preclinical and clinical studies investigated feasibility and efficacy of adoptive cell therapy (ACT) in EOC. The aim of this chapter is to present an overview of ACT in EOC, focusing on Human Leukocyte Antigen (HLA)-restricted tumor infiltrating lymphocytes and MHC-independent immune effectors such as natural killer and cytokine-induced killer. The available data suggest that ACT may provide the best outcome in patients with low tumor burden, minimal residual disease, or maintenance therapy. Further preclinical studies and clinical trials are needed.

Download Full-text

Synergistic effect of recombinant interferon-gamma and interleukin-3 on the growth of immature human hematopoietic progenitors

Blood ◽

10.1182/blood.v77.10.2118.2118 ◽

1991 ◽

Vol 77 (10) ◽

pp. 2118-2121 ◽

Cited By ~ 42

Author(s):

Y Kawano ◽

Y Takaue ◽

A Hirao ◽

T Abe ◽

S Saito ◽

...

Keyword(s):

Interferon Gamma ◽

Inhibitory Effect ◽

Human Interferon ◽

Dependent Manner ◽

Hematopoietic Progenitors ◽

Ifn Gamma ◽

Recombinant Interferon ◽

Interleukin 3 ◽

Liquid Suspension ◽

Colony Number

Abstract Purified peripheral blood hematopoietic progenitors from children in early remission from cancer respond to recombinant human interleukin-3 (IL-3), but not to granulocyte colony-stimulating factor (G-CSF). With these purified cells as a target, we studied the effect of recombinant human interferon-gamma (IFN-gamma) on progenitor growth, using both liquid-suspension limiting dilution assay (LDA) and regular methylcellulose culture of progenitors. We found that in LDA with IL-3, IFN-gamma directly stimulated the growth of blood progenitors in a dose- dependent manner with single-hit kinetics, whereas IFN-gamma suppressed the growth of G-CSF-supported progenitors obtained from bone marrow. The stimulatory effect was also observed in methylcellulose culture, but the addition of antibodies for G-CSF, granulocyte-macrophage CSF, IL-1 alpha, IL-1 beta, IL-6, or tumor necrosis factor did not result in a decrease of the colony number, supporting further the possible direct effect of IFN-gamma on progenitor growth. These results suggest that the inhibitory effect of IFN-gamma on hematopoietic progenitors is limited to those in an advanced stage of maturation. IFN-gamma may be one of the essential lymphokines upregulating the growth of human hematopoietic progenitor cells.

Download Full-text

Evaluation of serum CA 125 level as a tumor marker in borderline tumors of the ovary

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1993.03050299.x ◽

1993 ◽

Vol 3 (5) ◽

pp. 299-303 ◽

Cited By ~ 12

Author(s):

C. G. TropÉ ◽

A. Ph. Makar ◽

J. Kærn ◽

G. B. Kristensen ◽

I. Vergote ◽

...

Keyword(s):

Tumor Marker ◽

Residual Disease ◽

Elevated Serum ◽

Residual Tumor ◽

Ca 125 ◽

Disease Evolution ◽

Second Look ◽

Preoperative Serum ◽

Significant Difference ◽

Postoperative Serum

Serum CA 125 was evaluated as a tumor marker in 85 patients with borderline ovarian tumors. Serum CA 125 levels were elevated preoperatively in 18 of 20 (90%) samples (median 66, range 5–272 U ml−1). Preoperative serum CA 125 levels did not correlate to FIGO stage. Preoperative serum CA 125 levels were elevated in seven of nine (78%) with serous tumors (median 131, range 5–272 U ml−1) and in all 11 with mucinous tumors (median 62, range 41–157 U ml−1). There was no significant difference in the CA 125 levels between these two histologic types. Postoperative serum CA 125 levels, measured 3–6 weeks after primary laparotomy, were significantly lower than the preoperative ones (P< 0.001). No difference in the postoperative CA 125 levels was found between those with and those without residual disease after surgery. Postoperative serum CA 125 levels were elevated in eight of 60 (13%) without residual tumor. None of these had relapsed at the time of analysis (26–87 months after surgery). Serum CA 125 levels tended to correlate with disease evolution during chemotherapy. Two with disease remissions had falling levels, one with stable disease had falling level and one with disease progression had rising level. Serum CA 125 samples were obtained before second-look laparotomy in seven patients. Two with negative findings at second-look had normal levels. Of five with positive findings at laparotomy only two had elevated serum CA 125 levels. Disease relapse was associated with elevated serum CA 125 levels in only one of six patients.

Download Full-text