Mucinous carcinoma of the ovary (mucinous epithelial ovarian cancer [mEOC]) accounts for 7% to 14% of all primary epithelial ovarian cancer (EOC). It has been suggested that mEOC behaves differently to the more common histologic subtypes of EOC.
A recent case-control study by Hess suggested that mEOC is less responsive to platinum-based chemotherapy compared with other histologic subtypes of EOC. Furthermore, patients with advanced mEOC have a worse PFS and OS. The authors wrote: "The significant difference in platinum sensitivity of mEOC compared with other EOC, as demonstrated here, challenges the current practice of treating all patients with EOC with the same first-line chemotherapy regimen and raises the possibility that mEOC may represent a separate disease entity." This is echoed by GINECO experience. Alexandre et al concludes: "Advanced mEOC appears to be highly chemoresistant and complete resection of peritoneal metastases is unable to reverse its poor prognosis. New therapeutic options are needed."
At the same time, speciifc recommdnatiosn cannot yet be made fo this ovarian cancer subgroup. There are no guidelines that recommend 5FU based chemotherapies and there are no porospective comparative studies by which to be guided.
Xelox is an a study that includes newly diagnosed but not solely mucinous cancers: Carboplatin and Paclitaxel or Oxaliplatin and Capecitabine, With or Without Bevacizumab, as First-Line Therapy in Treating Patients With Newly Diagnosed Stage II, Stage III, Stage IV, or Recurrent Stage I Epithelial Ovarian Cancer or Fallopian Tube Cancer, NCT01081262.