A heavily pretreated patient with recurrent clear cell adenocarcinoma of the ovary in whom carcinomatous peritonitis was controlled successfully by salvage therapy with gemcitabine.

INTRODUCTION: Advanced clear cell adenocarcinoma of the ovary is a histologic type with an extremely poor prognosis. No reports have been published concerning useful drugs for salvage chemotherapy for this type of cancer. We performed salvage therapy with gemcitabine in a patient with multiple-drug- resistant, unresectable recurrent clear cell adenocarcinoma of the ovary and succeeded in stabilizing recurrent lesions and controlling carcinomatous peritonitis. CASE REPORT: A 55-year-old woman was in Stage IIIc of clear cell adenocarcinoma of the ovary. She had recurrent tumors after primary cytoreductive surgery, which were unresectable and also resistant to paclitaxel, carboplatin, irinotecan, and oral etoposide. After three courses of fourth-line chemotherapy with gemcitabine for the treatment of carcinomatous peritonitis and hepatic and splenic metastatic lesions, serum CA-125 and the severity of ascites showed marked decreases, and its efficacy for the hepatic and splenic metastatic lesions was classified as 5-month stable disease. The toxicity of this drug was in the acceptable range.
CONCLUSION: Gemcitabine is also useful for heavily pretreated clear cell adenocarcinoma of the ovary. It is necessary to consider the use of drugs without cross resistance to platinum and taxanes in the selection of drugs for this cancer.