A phase II study (JGOG3014) to

compare CPT-P and TC AZD0156 purchase for first-line treatment for CCC was conducted. The study revealed that completion rate of six cycles and five-year progression-free survival was similar in both arms [40]. Interesting to note, in the patients with residual tumor less than 2 cm, selleck overall survival was marginally improved in CPT-P group in comparison with TC group (p = 0.056). Subsequently, a phase III randomized study to compare CPT-P and TC as adjuvant chemotherapy for CCC is on-going (GCIG/JGOG3017) [41]. The winner regimen will be the first regimen for histologically individualized therapy for ovarian cancers. Another issue concerning chemotherapy for CCC is adjuvant therapy for patients with stage I disease. CCC is regarded as grade 3 tumor, and clinical guidelines recommend adjuvant chemotherapy for all patients with CCC, even at stage Ia. A large retrospective CA3 order analysis of stage I CCC revealed that there were no statistical differences of progression-free survival (PFS) and overall survival (OS) between patients with chemotherapy and without chemotherapy [16]. Also, multivariate analysis showed that peritoneal cytology

ADAMTS5 status (p = 0.02) and pT status (p = 0.04) were independent prognostic factors for PFS, however, adjuvant chemotherapy was not a prognostic factor (p = 0.80). The results suggested adjuvant chemotherapy had little impact upon survival of stage I CCC patients. Further strategy, such as a molecular targeting agent, is needed to improve survival of CCC, especially cases with positive peritoneal washing. Second-line

chemotherapy for CCC In a large series of platinum-sensitive relapsed ovarian tumors including all histological subtypes, overall response was 54% of the patients treated with the conventional platinum-based chemotherapy, and 66% of the cases treated with paclitaxel plus platinum chemotherapy [42]. In the platinum-resistant tumors, however, response rate using anti-cancer agents usually range from 25 to 30% [43]. In the second-line or salvage settings, the response rate for recurrent or refractory CCC was extremely lower than that for other histological tumors: even in the patients with platinum-sensitive CCC disease, the response rate reported was lower than 10% [44, 45]. So, we have summarized reported cases that achieved objective response (Table 4) [30, 33, 44–48].