Endometrioid Ovarian Carcinoma Benefits from Aromatase Inhibitors: Case Report and Literature Review

Aromatase inhibitors have not been adequately assessed in treatment of ovarian cancer. The aromatase inhibitor letrozole (2.5 mg daily) was administered in 2 cases of advanced endometrioid ovarian cancer with positive estrogen receptor. Case 1: A 52-year-old woman with a grade 2–3, stage IIIC endometrioid ovarian cancer was optimally debulked and received 6 cycles of intravenous paclitaxel and intraperitoneal cisplatin–paclitaxel. Post chemotherapy, one of several biopsies showed residual disease during the second-look laparoscopy. This patient was treated with letrozole and remained disease-free during 30 months of follow-up. Case 2: A 47-year-old woman with a grade 3, stage IIIC endometrioid ovarian cancer was optimally debulked and treated with intravenous carboplatin–paclitaxel. After a 15-month remission, her first recurrent disease was treated with carboplatin–docetaxel. The second remission lasted only 11 months, after which the patient was treated with splenectomy and subsequent liposomal doxorubicin. Letrozole was administered after the chemotherapy. The patient had a 30-month remission before the next recurrence of her disease. Conclusions: Endometrioid ovarian carcinoma may benefit from aromatase inhibitors, especially when the tumour burden is low after primary chemotherapy or when the inhibitor is used as maintenance therapy between chemotherapies.