Initial management and long-term outcome of ovarian clear cell carcinoma (OCCC) in the French multicentre ESME database

BackgroundOCCC is a rare and distinct type of epithelial ovarian cancer. Given its high prevalence among Asian women, few real-life data on large sized Caucasian cohort are available.MethodsWe conducted a multicentre retrospective analysis of OCCC patients selected from the French ESME Ovarian Cancer database between 2003 and 2019. This database includes all ovarian cancer pts treated in 18 French Comprehensive Cancer Centres. The main objective was to describe the management of these patients. Secondary objectives were to analyse progression-free survival (PFS), overall survival (OS) and prognostic factors in the stage III/IV population.ResultsWithin the 13032 ovarian cancer pts in the cohort database, 300 OCCC pts matched inclusion criteria. Median age was 56.9y (23.0-89.7). 271 (57%) pts were diagnosed at an early stage (FIGO IA/B, (n=76); FIGO IC (n=56), FIGO II (n=22)) and 129 (43%) pts had FIGO III/IV disease. Lymph node involvement was present in 68 (22.7%) patients. Surgery was combined with adjuvant chemotherapy (CT) in 52 (73.2%) FIGO stage IA/IB pts and 48 (88.9%) FIGO stage IC patients. In stage III/IV patients, 71 (55.0%) pts underwent primary debulking surgery + adjuvant CT, 19 (14.7%) NACT and interval debulking surgery. 33 (25.6%) received only CT and 6 surgery alone. In stage III/IV pts, 42 (77.8%, n=96 with available data) underwent complete surgery. CT was combined with bevacizumab in 34.9% (n=45) of stage III/IV. The median follow-up was 64.3 months (95% CI: 57.4-70.5). PFS rate at 3y was 74.0% (66.9-81.9) and 58.7% (41.3-83.6) in FIGO I and II respectively while OS rate at 5y was 83.1% (76.5-90.2) and 53.4% (34.4-82.9). PFS rate at 3y was 79.7% (69,9-91.4) and 47.9% (26.5-86.6) in FIGO IA/B patients with or without adjuvant CT respectively. In stage III and IV, median PFS was 14.0m (11.8-19.0) and 6.8m (4.0-12.0) respectively and median OS was 35.8m (4-46.4) and 15.5m (9.2-32.9).ConclusionsIn this large Caucasian cohort of OCCC with a long follow-up, early stage OCCC pts have a significant risk of relapse while patients diagnosed with advanced disease have a dismal prognosis. The French TMRG (Malignant Tumors Rare Gynecological) network supporting diagnosis and management of this rare tumor with updated guidelines.Clinical trial identificationNCT03275298.Legal entity responsible for the studyUnicancer / Institut de Cancérologie de L’Ouest.FundingThe ESME OC database receives financial support from industrial partners. Unicancer manages ESME databases independently (i.e. data collection, analysis and publication) and is the sole data controller for data processing.DisclosureM.J. Rodrigues: Financial Interests, Personal, Advisory Board: GSK, AstraZeneca, MSD, Immunocore; Financial Interests, Institutional, Advisory Board: AstraZeneca, MSD; Other, Institutional, Other, President French Society of Cancer (SFC): French Society of Cancer (SFC). I.L. Ray-Coquard: Financial Interests, Personal, Advisory Board: Roche, GSK, AstraZeneca, Mersana, Deciphera, Amgen, Oxnea, Merck Sereno, Agenus, Novartis, Macrogenics, Clovis, EQRX, adaptimmun, Eisai, Sutro, BMS, Adaptimmune, Daichi-Santyo, ImmunoGen, Seagen, PMV Pharma; Financial Interests, Institutional, Other, COLIBRI translational research: BMS; Financial Interests, Institutional, Advisory Board, translational research NEOPREMBROV trial: MSD; Non-Financial Interests, Principal Investigator: PAOLA1; Non-Financial Interests, Other, President: GINECO. L. Gladieff: Financial Interests, Personal, Other, Congress funding: Viatris, Roche; Financial Interests, Institutional, Invited Speaker: MSD, Clovis, GSK, Eisai; Financial Interests, Institutional, Advisory Board: Clovis, GSK; Financial Interests, Personal, Invited Speaker: AstraZeneca. P. Colombo: Financial Interests, Personal, Invited Speaker: GSK, MSD. R. Sabatier: Financial Interests, Personal, Other, Consulting: GSK, MSD; Financial Interests, Personal, Invited Speaker: Eisai, Clovis Oncology, GSK; Financial Interests, Personal, Advisory Board: Seagen Oncology; Financial Interests, Institutional, Research Grant: Astra-Zeneca; Non-Financial Interests, Other, Travel fees: MSD, Novartis; Non-Financial Interests, Other, Congress fees: GSK. F. Joly Lobbedez: Financial Interests, Personal, Advisory Board: GSK, AstraZeneca, MSD, Janssen, Ipsen, Bayer, Astellas, Eisai, Seagen, Novocure, Pfizer; Financial Interests, Personal, Invited Speaker: GSK, AstraZeneca, MSD, Janssen, Ipsen, Amgen, Novartis/3A, Eisai, Amgen, Eisai; Financial Interests, Institutional, Invited Speaker: Viatris; Financial Interests, Institutional, Coordinating PI: GSK, AstraZeneca; Financial Interests, Institutional, Research Grant: BMS, Astellas; Financial Interests, Institutional, Funding: Janssen; Non-Financial Interests, Member: GCIG; Other, travel and congress: MSD, Ipsen, Chugai; Other, travel: GSK, Eisai. T.-. De La Motte Rouge: Financial Interests, Personal, Advisory Board: Pfizer, AstraZeneca, GSK, Clovis Oncology, Roche, Msd, Mylan, Tesaro, Gilead, Sanofi, Seagen; Financial Interests, Personal, Invited Speaker: Novartis; Financial Interests, Institutional, Research Grant: Novartis, Pfizer, MSD, Seagen; Financial Interests, Institutional, Local PI: Roche, AstraZeneca, GSK, MSD, Pfizer, Netris Pharma; Financial Interests, Personal, Steering Committee Member: MSD; Non-Financial Interests, Advisory Role: French National Cancer Institute, UNICANCER; Non-Financial Interests, Principal Investigator: Arcagy, Unicancer; Non-Financial Interests, Other, Co-Principal Investigator: Unicancer; Non-Financial Interests, Other, partnership using a Natera solution for a clinical trial funded by academic grant: NATERA. C. Pomel: Financial Interests, Personal, Advisory Board: Roche, Roche, GSK, PharmaMar, MSD; Financial Interests, Personal, Invited Speaker: Roche, GSK, PharmaMar. C. Lebreton: Financial Interests, Personal, Advisory Board: GSK, GSK, MSD, Eisai, Clovis Oncology. P. Pautier: Financial Interests, Personal, Advisory Board, 2015, 2022: PharmaMar; Financial Interests, Institutional, Advisory Board, 2020: Roche, Clovis; Financial Interests, Institutional, Advisory Board, 2021: AstraZeneca; Financial Interests, Personal, Advisory Board, 2019-2020: AstraZeneca; Financial Interests, Institutional, Advisory Board: GSK; Financial Interests, Personal, Advisory Board, 2018-2019: Roche; Financial Interests, Institutional, Advisory Board, 2022: MSD; Financial Interests, Personal and Institutional, Research Grant: PharmaMar; Financial Interests, Research Grant: ONXEO. P. Follana: Financial Interests, Personal, Invited Speaker: GSK, Eisai, MSD; Financial Interests, Personal, Advisory Board: AZ, Novartis; Financial Interests, Personal, Other, Congress invitation: Gilead. L. Bosquet: Financial Interests, Institutional, Full or part-time Employment, In charge of scientific projects at Unicancer, Health Data and Partnership Department: Unicancer. J. Frenel: Financial Interests, Personal, Advisory Board: Pfizer, Novocure, Pierre Fabre, Eisai, Seagen, Gilead; Financial Interests, Personal, Invited Speaker: GSK, Amgen, Eisai; Financial Interests, Institutional, Advisory Board: Exactscience, Lilly, Daiichi Sankyo, AstraZeneca, Clovis Oncology; Financial Interests, Institutional, Invited Speaker: Novartis, MSD; Financial Interests, Coordinating PI: AstraZeneca, Seagen; Financial Interests, Local PI: MSD, Daiichi; Non-Financial Interests, Principal Investigator: Novartis, Lilly, Astra Zeneca, Pfizer, Daiichi, MSD. P. Augereau: Financial Interests, Institutional, Advisory Board: AZ Daiichi, MSD; Financial Interests, Institutional, Invited Speaker: GSK, Novartis, Seagen. All other authors have declared no conflicts of interest.