Ongoing Clinical Trials for Ovarian Borderline Cancer
Yes, there are ongoing clinical trials for ovarian borderline cancer, though they are limited compared to invasive ovarian cancer trials and often part of larger studies that include multiple rare ovarian tumor types. 1
Current Clinical Trial Landscape
Types of Available Trials
- International collaborative trials are necessary for rare tumor types like borderline ovarian tumors
- The ALIENOR/ENGOT-ov7 study demonstrated that randomized trials can be completed with international collaboration for rare ovarian tumor types 1
- Trials often include borderline tumors as part of larger studies focusing on:
- Fertility preservation approaches
- Surgical techniques (conservative vs. radical)
- Management of peritoneal implants
Trial Design Considerations
- For very rare tumor types like borderline ovarian cancer, trials often use:
- Parallel clinical trials with harmonized protocols
- Combined final analysis across multiple centers
- Comparison of single-arm studies with historical controls
- Real-world data sets to facilitate comparisons 1
Research Priorities
Surgical Management
- Trials comparing conservative (fertility-sparing) surgery versus standard cytoreductive surgery
- Studies evaluating the role of minimally invasive approaches (laparoscopy vs. laparotomy) 2
- Evaluation of surgical approaches for peritoneal implants
Adjuvant Treatment
- Limited evidence supports adjuvant therapy for borderline tumors without invasive implants 3
- Trials evaluating the benefit of adjuvant therapy for borderline tumors with invasive implants 2
- Studies of targeted therapies in specific molecular subtypes
Patient Selection for Trials
Eligibility Considerations
- Histological confirmation with centralized pathology review is essential 1
- Stratification based on:
- Presence/absence of invasive implants
- Histological subtype (serous vs. mucinous)
- Stage of disease
- Previous fertility-sparing surgery
Challenges in Trial Recruitment
- Low incidence of borderline tumors (approximately 15% of epithelial ovarian cancers) 4
- Excellent overall prognosis (5-year survival exceeding 80%) 1
- Need for long follow-up periods to detect meaningful differences in outcomes
Future Directions
- Development of molecular biomarkers to identify borderline tumors at risk of malignant transformation
- Quality of life studies focusing on fertility preservation outcomes
- Construction of reliable contemporary real-world data sets to facilitate comparison of treatment approaches 1
- International collaboration to achieve sufficient patient numbers for meaningful statistical analysis
Practical Advice for Patients
- Patients interested in clinical trials should:
- Consult with gynecologic oncologists at major academic centers
- Consider international trial options through collaborative groups
- Discuss fertility preservation options if relevant
- Understand that borderline tumors generally have excellent prognosis even without adjuvant therapy 3
The management of borderline ovarian tumors remains primarily surgical, with limited evidence supporting adjuvant treatments. Clinical trials are essential to establish optimal management strategies, particularly for patients with invasive implants or recurrent disease.