Clear cell ovarian cancer grows out of endometriosis, is usually caught early and cured by surgery, but when advanced it resists platinum chemotherapy. Its distinct genetics, with ARID1A and PIK3CA mutations, are the focus of targeted and immune approaches.
Clear cell carcinoma is strongly associated with endometriosis and is commoner in East Asian women. About half carry ARID1A mutations and a third PIK3CA mutations; TP53 is usually wild-type. It presents as a large unilateral mass, often at stage I, with a raised risk of venous thromboembolism and hypercalcaemia. Surgery is curative for most early disease, with adjuvant carboplatin-paclitaxel for stage IC and above; advanced and recurrent disease respond poorly to chemotherapy and do not benefit from PARP inhibitors. Immune checkpoint inhibitors have produced responses in a minority, and trials target ARID1A loss (ATR and EZH2 inhibitors), PI3K and the hypoxia pathway.
About one in ten ovarian cancers in Western countries and a quarter in Japan; most present at an early stage and are cured, but advanced disease responds poorly to chemotherapy and carries a worse outlook than high-grade serous cancer.
Most high-grade ovarian cancers begin at the tip of the fallopian tube; endometrial cancer lines the uterus, cervical cancer starts at the transformation zone; each drains to a different node group.
Same organ: Adenosquamous carcinoma of the cervix, Small cell neuroendocrine carcinoma of the cervix, Bartholin gland carcinoma, Vulvar melanoma, Vaginal melanoma, High-grade serous ovarian cancer, Low-grade serous ovarian cancer, Mucinous ovarian cancer, Adult granulosa cell tumour of the ovary, Ovarian cancer, Endometrial cancer, Cervical cancer, Vulvar cancer, Gestational trophoblastic neoplasia, Uterine sarcoma, Vaginal cancer, POLE-ultramutated endometrial cancer, Mismatch-repair-deficient endometrial cancer, p53-abnormal endometrial cancer, including uterine serous carcinoma, Endometrial cancer with no specific molecular profile, Advanced or recurrent endometrial cancer, Uterine carcinosarcoma, Early cervical cancer and fertility-sparing surgery, Locally advanced cervical cancer, Recurrent or metastatic cervical cancer, Platinum-sensitive ovarian cancer, Platinum-resistant ovarian cancer, HPV-associated vulvar squamous cell carcinoma, HPV-independent vulvar squamous cell carcinoma (p53-mutant), Vaginal squamous cell carcinoma (HPV-associated), Vaginal adenocarcinoma (including DES-associated clear cell adenocarcinoma), Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6), High-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk), Placental-site trophoblastic tumour and epithelioid trophoblastic tumour
Complete staging surgery; adjuvant carboplatin-paclitaxel for stage IC and above; observation may be considered for stage IA.
Cytoreduction and platinum-based chemotherapy despite modest responses; clinical trials of immunotherapy and ARID1A-directed drugs are preferred where available.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
ARID1A loss defines the biology of clear cell ovarian cancer and is the target of current trials of synthetic-lethal drugs such as ATR and EZH2 inhibitors.
Together with the Wiegand study, this defined clear cell ovarian cancer as a chromatin remodelling-driven disease distinct from high-grade serous cancer.
Query for this cancer: (TITLE:"Clear cell ovarian cancer" OR ABSTRACT:"Clear cell ovarian cancer" OR TITLE:"Ovarian clear cell carcinoma" OR ABSTRACT:"Ovarian clear cell carcinoma" OR TITLE:"OCCC" OR ABSTRACT:"OCCC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Clear cell ovarian cancer, not a curated reading list.
The targets of this cancer's medicines and the ones linked to it directly.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
No pharmacokinetic interactions expected (antibody). See the irAE guide for toxicity management.
Dose by Calvert formula using GFR (see the calculators).
During chemotherapy a temperature over 37.5 C or below 36 C, shivering, or feeling unwell even with a normal temperature means ringing the hospital's 24-hour line straight away; breathing very fast, confusion, mottled skin or no urine in a day means 999.
Eyebrows and eyelashes usually fall later than scalp hair and come back later, and their absence is felt more than people expect, because they frame the face and keep dust and sweat out of the eyes.
See all on the product pages:CarboplatinPaclitaxel / nab-paclitaxelPembrolizumab·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Clear cell ovarian cancer, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.