Mucinous ovarian cancer
Mucinous ovarian cancer is rare, usually confined to one large ovary at diagnosis and cured by surgery. Its genetics resemble bowel cancer more than ovarian cancer, and pathologists must first rule out a spread from the gut before making the diagnosis.
Overview
Primary mucinous carcinoma of the ovary is uncommon and was historically over-diagnosed because metastases from the appendix, colon, stomach and pancreas mimic it. True primary tumours carry KRAS mutations in about two thirds and HER2 amplification in a fifth, share their biology with gastrointestinal cancers and often arise from a mucinous borderline tumour. Most are stage I and treated with surgery alone or with fertility-sparing unilateral oophorectomy; appendicectomy is performed if the appendix looks abnormal. Advanced disease responds poorly to carboplatin-paclitaxel, and gastrointestinal-type regimens such as capecitabine-oxaliplatin are used by extrapolation; HER2-directed therapy is an option in amplified tumours.
State of the art
- Strict pathology criteria have cut the diagnosis to its true rare frequency and improved apparent survival.
- The GI-like biology is steering treatment toward bowel cancer regimens and HER2-directed therapy.
- International rare-tumour trials (mEOC/GOG 241) showed how hard it is to recruit for this disease.
Anatomy and lymph node drainage
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.
- Fallopian tube fimbria (origin of high-grade serous)
- Ovary (other histologies, germ cell)Arising from mucinous borderline tumour or teratoma
- EndometriumHER2-amplified
- Myometrium (uterine sarcoma)
- Placental site (gestational trophoblastic)Expansile (confluent) pattern (better outlook)
- Cervix, transformation zone
- Vulva
- obturator and external iliac
- internal iliac
- para-aortic (ovary, high uterus)
- inguinal (vulva)
Same organ: High-grade serous ovarian cancer, Low-grade serous ovarian cancer, Clear cell ovarian cancer, Adult granulosa cell tumour of the ovary, Ovarian cancer, Endometrial cancer, Cervical cancer, Vulvar cancer, Gestational trophoblastic neoplasia, Uterine sarcoma, Vaginal cancer
About three percent of ovarian cancers once metastases from the bowel and appendix are excluded; most are large, unilateral stage I tumours that surgery cures, and the rare advanced cases respond poorly to standard ovarian regimens.
- AI in radiologyEstablished
- cfDNA fragmentomicsEstablished
- Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)Standard of care
- DNA methylation profilingEstablished
- HCC surveillance in cirrhosis (ultrasound + AFP)Standard of care
- High-risk pancreatic surveillance (CAPS / PRECEDE)Established
- A 28-day national pathway for people with a positive multi-cancer blood test
- A breath test to rule out cancer in people with vague symptoms
- A cancer blood test for older people arriving at A&E with unexplained symptoms
- A legislated, publicly reported 28-day standard from urgent referral to diagnosis
- A live national dashboard of stage at diagnosis as the scorecard for early detection
- A single 'cancer check at 60' appointment bundling all screening tests
Background: Alpha-fetoprotein (AFP), Barrett's oesophagus, CA 19-9, Early detection, Faecal immunochemical test (FIT). Also on OnCo: Symptoms and red flags · Early detection roadmap.
Cases by country
No country-level case numbers. This cancer is not mapped to a GLOBOCAN site.
Unilateral salpingo-oophorectomy or hysterectomy with staging; appendicectomy if abnormal; chemotherapy usually omitted for stage IA and IB.
Cytoreduction; carboplatin-paclitaxel or gastrointestinal-type capecitabine-oxaliplatin; trastuzumab for HER2-amplified tumours in trials.
Subtypes & biomarkers
top- Expansile (confluent) pattern (better outlook)
- Infiltrative pattern
- HER2-amplified
- Arising from mucinous borderline tumour or teratoma
- KRAS mutation
- HER2 amplification (about 20 percent)
- CK7 and CK20 pattern and SATB2 to exclude gastrointestinal origin
- CEA and CA 19-9 rather than CA-125
How often this target appears
- 2003Seidman shows most 'mucinous ovarian cancers' are metastases from the gut
- 2019mEOC/GOG 241 randomised trial closes early for poor accrual
What is in development for Mucinous ovarian cancer, drawn from the whole corpus: 0 items. Drugs are grouped by the most advanced trial phase they have reached anywhere; approved treatments sit under standard of care. Technologies are the methods being tested for this cancer, trials are the studies recorded here, and ideas are proposals not yet in a trial.
Nothing recorded in development for this cancer yet.
Open problems and what is being done
No proven chemotherapy for advanced disease.
and how the field plans to fix it →What is being done about thisAdvanced and metastatic diseaseAvailable now- Bone-modifying agents (bisphosphonates, denosumab)Standard of care
- DordaviproneApproved
- HIPEC / PIPAC (intraperitoneal chemotherapy)Established
- Laser interstitial thermal therapy (LITT)Established
- Liquid biopsy (ctDNA)Standard of care
- Lutetium-177 vipivotide tetraxetanApproved
In trials- ACTIONRecruiting
- CAR-T for glioma (IL13Rα2, GD2, EGFRvIII, multi-target)Phase 1
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- DESTINY-Breast12Positive
- DYNAMICPositive
- EF-14Positive
Ideas and roadmaps- A billion-dollar prize for the first durable cure of a lethal metastatic cancer
- A blood test for the pre-metastatic niche
- A global rapid tissue donation network for metastatic disease
- A national rapid research autopsy network for end-stage cancer
- A regulatory endpoint for drugs that block spread, not tumours
- A ring-fenced metastasis programme with metastasis-specific endpoints
Background: Blood-brain barrier (BBB), Circulating tumour DNA (ctDNA), EGFRvIII, Epithelial-mesenchymal transition & drug efflux, H3 K27M (diffuse midline glioma). Also on OnCo: Atlas of advanced disease · Invasion and metastasis.
Trials cannot recruit enough patients.
Distinguishing primary from metastatic disease still needs expert pathology.
and how the field plans to fix it →What is being done about thisAdvanced and metastatic diseaseAvailable now- Bone-modifying agents (bisphosphonates, denosumab)Standard of care
- DordaviproneApproved
- HIPEC / PIPAC (intraperitoneal chemotherapy)Established
- Laser interstitial thermal therapy (LITT)Established
- Liquid biopsy (ctDNA)Standard of care
- Lutetium-177 vipivotide tetraxetanApproved
In trials- ACTIONRecruiting
- CAR-T for glioma (IL13Rα2, GD2, EGFRvIII, multi-target)Phase 1
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- DESTINY-Breast12Positive
- DYNAMICPositive
- EF-14Positive
Ideas and roadmaps- A billion-dollar prize for the first durable cure of a lethal metastatic cancer
- A blood test for the pre-metastatic niche
- A global rapid tissue donation network for metastatic disease
- A national rapid research autopsy network for end-stage cancer
- A regulatory endpoint for drugs that block spread, not tumours
- A ring-fenced metastasis programme with metastasis-specific endpoints
Background: Blood-brain barrier (BBB), Circulating tumour DNA (ctDNA), EGFRvIII, Epithelial-mesenchymal transition & drug efflux, H3 K27M (diffuse midline glioma). Also on OnCo: Atlas of advanced disease · Invasion and metastasis.
Trials
topTrials recruiting now
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Expert centres
topExpert centres
- via Ovarian cancer
- Alliance for Clinical Trials in OncologyChicago, IL, USvia Carboplatin
- ARCAGY-GINECOParis, FRvia Ovarian cancer
- BC CancerVancouver, BC, CAvia Ovarian cancer
- Breast Cancer TrialsNewcastle, NSW, AUvia Trastuzumab
- Breast International Group (BIG)Brussels, BEvia Trastuzumab
- via Ovarian cancer
- Central Drugs Standard Control OrganizationNew Delhi, INvia Trastuzumab
- Centre hospitalier de l'Université de Montréal (CHUM)Montréal, QC, CAvia Ovarian cancer
- Centre Oscar LambretLille, FRvia Ovarian cancer
- Chris O'Brien LifehouseSydney, AUvia Ovarian cancer
- Edinburgh Cancer Centre / CRUK Scotland CentreEdinburgh, GBvia Ovarian cancer
- via Ovarian cancer
- via Trastuzumab
- German Breast Group (GBG)Neu-Isenburg, DEvia Carboplatin
- GOG FoundationPhiladelphia, PA, USvia Ovarian cancer
- via Trastuzumab
- Institut BergoniéBordeaux, FRvia Ovarian cancer
- Institut Jules BordetBrussels, BEvia Trastuzumab
- Institute of Oncology LjubljanaLjubljana, SIvia Carboplatin
- Instituto Alexander FlemingBuenos Aires, ARvia Trastuzumab
- via Ovarian cancer
- IRCCS Ospedale San RaffaeleMilan, ITvia Trastuzumab
- via Ovarian cancer
- Istituto di Candiolo IRCCS (FPO)Candiolo, ITvia Trastuzumab
- Istituto Oncologico Veneto IRCCSPadua, ITvia Trastuzumab
- via Ovarian cancer
- Newcastle Cancer Centre / Northern Centre for Cancer CareNewcastle upon Tyne, GBvia Ovarian cancer
- Northwell Health Cancer InstituteNew Hyde Park, NY, USvia Ovarian cancer
- NSABP FoundationPittsburgh, PA, USvia Trastuzumab
- via Ovarian cancer
- Ontario Institute for Cancer ResearchToronto, ON, CAvia Ovarian cancer
- via Ovarian cancer
- Peking Union Medical College HospitalBeijing, CNvia Ovarian cancer
- QIMR Berghofer Medical Research InstituteBrisbane, AUvia Ovarian cancer
- Shaare Zedek Medical CenterJerusalem, ILvia Ovarian cancer
- Society of Gynecologic OncologyChicago, IL, USvia Ovarian cancer
- SOLTI Cancer Research GroupBarcelona, ESvia Trastuzumab
- via Ovarian cancer
- via Ovarian cancer
- via Ovarian cancer
- via Trastuzumab
- via Ovarian cancer
- UZ Leuven / Leuven Cancer InstituteLeuven, BEvia Ovarian cancer
Questions to ask
topQuestions to ask your oncologist about Mucinous ovarian cancer
Newly diagnosed
- What is my exact diagnosis, stage, and grade, and which tests established them?Why: Everything else follows from an accurate stage and subtype.
- Which biomarkers have been tested on my tumour (for example KRAS mutation, HER2 amplification, CK7 and CK20 pattern and SATB2 to exclude gastrointestinal origin, CEA and CA 19-9 rather than CA-125), and what were the results?Why: These results decide eligibility for targeted therapy, immunotherapy, and trials.
- Which subtype is my cancer, and does that change the recommended treatment?Why: Recognised subtypes for this cancer include Expansilepattern, Infiltrative pattern, HER2-amplified.
- Is germline (inherited) genetic testing recommended for me or my family?Why: Inherited variants can change treatment and matter for relatives.
Early stage
- For my situation (early stage), which of the standard options do you recommend and why?Why: Guideline options include: Unilateral salpingo-oophorectomy or hysterectomy with staging; appendicectomy if abnormal; chemotherapy usually omitted for stage IA and IB.
Advanced or recurrent
- For my situation (advanced or recurrent), which of the standard options do you recommend and why?Why: Guideline options include: Cytoreduction; carboplatin-paclitaxel or gastrointestinal-type capecitabine-oxaliplatin; trastuzumab for HER2-amplified tumours in trials.
- Am I a candidate for Capecitabine, Oxaliplatin, Trastuzumab or related drugs, and what side effects should I expect?Why: Knowing the expected toxicities helps you plan work, family, and supportive care.
Any stage
- Would a second opinion at a high-volume centre change anything, and can you help arrange it?Why: Rare or high-stakes decisions benefit from a centre that treats many similar patients.
- What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?Why: Supportive care improves quality of life and helps patients complete treatment.
- I read that “No proven chemotherapy for advanced disease”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
- I read that “Trials cannot recruit enough patients”. How does that affect my plan?Why: Open problems are where trials and second opinions matter most.
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Direct links plus the targets, companies, and technologies of this cancer's products.
technologies
3targets
1drugs
4companies
2Latest papers
topQuery for this cancer: (TITLE:"Mucinous ovarian cancer" OR ABSTRACT:"Mucinous ovarian cancer" OR TITLE:"Mucinous ovarian carcinoma" OR ABSTRACT:"Mucinous ovarian carcinoma" OR TITLE:"MOC" OR ABSTRACT:"MOC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Mucinous ovarian cancer, not a curated reading list.
Similar pages
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- CancerClear cell ovarian cancer
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- CancerLow-grade serous ovarian cancer
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- CancerOesophageal and junctional adenocarcinoma
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- CancerHigh-grade serous ovarian cancer
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- CancerOesophageal squamous cell carcinoma
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- TrialA Study of RC48-ADC Combination Therapies as First-line Treatment in Advanced Metastatic Gastric Cancer
Shares Oxaliplatin, Capecitabine, Trastuzumab.