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Background <p>There is a rising incidence of platinum-resistant ovarian cancer cases. Other therapeutic&#xa0;options,&#xa0;including hormonal therapy and target&#xa0;therapy, have been under trial.</p> Aim <p>Determining the outcome of hormonal therapy in platinum-resistant ovarian cancer and its correlation to estrogen receptors (ERs) <i>α</i> and <i>β</i> expression in specimens from primary laparotomies.</p> Methods <p>This is a retrospective cohort study conducted&#xa0;on 64 ovarian cancer patients presented to our center with platinum resistance.&#xa0;Patients&#xa0;were divided&#xa0;into&#xa0;two&#xa0;groups:&#xa0;22 patients&#xa0;(34.40%) received&#xa0;Tamoxifen and 42 patients (65.6%) received aromatase inhibitors (AIs). Hysterectomy specimens&#xa0;were assessed&#xa0;to determine the histological type, grade, stage, and lymphovascular invasion (LVI). Sections from ovarian tumors were immune stained with antibodies for ER <i>α</i> and <i>β</i>. Both&#xa0;groups,&#xa0;receiving either&#xa0;drug,&#xa0;were compared regarding the development of progressive disease, disease-free survival, overall survival, and predictor value of each estrogen receptor. Estrogen receptor expression&#xa0;was correlated&#xa0;with disease-free survival (DFS) and overall survival (OS).</p> Results <p>There was no statistically significant difference between both groups regarding&#xa0;age, stage, or overall performance state. Similarly, they were the protocol for primary treatment, the&#xa0;pattern of recurrence or metastases, and disease-free duration after primary treatment. Regarding pathological data, the&#xa0;majority of cases were high-grade serous carcinoma. ERα was positive in the majority of cases&#xa0;(78% of cases)&#xa0;either&#xa0;alone or in combination with ERβ.&#xa0;Percentage&#xa0;of patients who developed progressive disease after 3 and 6&#xa0;months was slightly lower for AIs&#xa0;compared to&#xa0;tamoxifen&#xa0;but without&#xa0;a statistically significant difference.&#xa0;Similarly, it was the overall survival, where cases receiving AIs had more prolonged survival than those receiving&#xa0;tamoxifen&#xa0;but without statistically significant difference. Disease-free survival was nearly similar in both groups. Cases with positive expression of ERα had longer DFS but shorter OS without statistically&#xa0;significant&#xa0;values. Cases with negative expression of ERβ showed longer DFS and OS but without statistically significant values. When correlated with hormonal therapy,&#xa0;positive&#xa0;expression of both receptors showed longer overall survival in the AIs group.</p> Conclusion <p>There is no statistically significant difference regarding clinical benefit, disease-free survival, or overall survival between tamoxifen and aromatase inhibitors. Estrogen receptor alpha and beta expression has no statistically significant effect regarding response to hormonal therapy nor survival. Gross residual disease, duration of hormonal therapy, and first treatment duration were the statistically significant factors affecting OS. These results need to be validated on a larger population of patients.</p>

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Platinum-Resistant Ovarian Carcinoma: Role of Anti-estrogen Therapy and Correlation with Hormone Receptor Expression

  • 期刊论文

  • 发表日期：

    2025年1月18日

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  • Ahmed El-Horigy,
  • Manal Salah-Eldin,
  • Hayam F. Ghazy,
  • Zaid Emarah,
  • Ahmed E. Eladl,
  • Reham Mohamed Nagib

摘要

Background

There is a rising incidence of platinum-resistant ovarian cancer cases. Other therapeutic options, including hormonal therapy and target therapy, have been under trial.

Aim

Determining the outcome of hormonal therapy in platinum-resistant ovarian cancer and its correlation to estrogen receptors (ERs) α and β expression in specimens from primary laparotomies.

Methods

This is a retrospective cohort study conducted on 64 ovarian cancer patients presented to our center with platinum resistance. Patients were divided into two groups: 22 patients (34.40%) received Tamoxifen and 42 patients (65.6%) received aromatase inhibitors (AIs). Hysterectomy specimens were assessed to determine the histological type, grade, stage, and lymphovascular invasion (LVI). Sections from ovarian tumors were immune stained with antibodies for ER α and β. Both groups, receiving either drug, were compared regarding the development of progressive disease, disease-free survival, overall survival, and predictor value of each estrogen receptor. Estrogen receptor expression was correlated with disease-free survival (DFS) and overall survival (OS).

Results

There was no statistically significant difference between both groups regarding age, stage, or overall performance state. Similarly, they were the protocol for primary treatment, the pattern of recurrence or metastases, and disease-free duration after primary treatment. Regarding pathological data, the majority of cases were high-grade serous carcinoma. ERα was positive in the majority of cases (78% of cases) either alone or in combination with ERβ. Percentage of patients who developed progressive disease after 3 and 6 months was slightly lower for AIs compared to tamoxifen but without a statistically significant difference. Similarly, it was the overall survival, where cases receiving AIs had more prolonged survival than those receiving tamoxifen but without statistically significant difference. Disease-free survival was nearly similar in both groups. Cases with positive expression of ERα had longer DFS but shorter OS without statistically significant values. Cases with negative expression of ERβ showed longer DFS and OS but without statistically significant values. When correlated with hormonal therapy, positive expression of both receptors showed longer overall survival in the AIs group.

Conclusion

There is no statistically significant difference regarding clinical benefit, disease-free survival, or overall survival between tamoxifen and aromatase inhibitors. Estrogen receptor alpha and beta expression has no statistically significant effect regarding response to hormonal therapy nor survival. Gross residual disease, duration of hormonal therapy, and first treatment duration were the statistically significant factors affecting OS. These results need to be validated on a larger population of patients.