Ovarian Carcinosarcoma: Update on a Rare Malignancy
Posted: Monday, March 11, 2019
Comprising just 1% to 4% of all ovarian cancers, ovarian carcinosarcomas are aggressive tumors with poor survival outcomes and few prospective data. Stergios Boussios, MD, PhD, of the Medway NHS Foundation Trust, Kent, United Kingdom, and his colleagues published an article in Critical Reviews in Oncology/Hematology describing what we know and don’t know about these rare ovarian malignancies.
The researchers combined the findings of publications, clinical trials, and scientific meeting abstracts from 1982 to 2018 in their review. Through their analysis, it was determined that ovarian carcinosarcoma typically presents later than most other ovarian cancers, generally at stage III or IV. Approximately 90% of women have disease spread beyond the ovaries at the time of diagnosis, and 33% of cases involve both ovaries.
The prognosis for these women is impacted by various factors, such as the number of small vessels in the primary tumor, increased VEGF, mutation of p53, and suboptimal surgical debulking. One study suggests that patients with tumors positive for CD8 T cells and negative for PD-L1 expression seem to have better overall survival.
Treatments typically consist of surgery, systemic therapies such as platinum-based chemotherapy, and targeted therapies. The addition of paclitaxel or ifosfamide may be useful in combination with platinum-based chemotherapy for a subset of patients. The authors noted the need for further study to fully understand the patterns of chemotherapy use in women with ovarian carcinosarcoma. In addition, targeting the PD-L1 antigen or CD8 T cells may be viable in future immunotherapies.
Disclosure: The study authors’ disclosure information may be found at sciencedirect.com.