Ovarian Cancer

Itraconazole has intriguing retrospective-combination data in recurrent ovarian clear cell carcinoma and refractory ovarian cancer more broadly, but the evidence is still early and off-label.

Overview

The main clinical interest here is itraconazole given with chemotherapy in difficult recurrent or refractory settings, where standard cytotoxic agents often have poor response rates.

Key human data

• In a Japanese retrospective series of nine patients with recurrent ovarian clear cell carcinoma, itraconazole 400 mg daily was given for four days every two weeks alongside docetaxel- and carboplatin-based chemotherapy.

• In that clear-cell cohort, the response rate was 44%. Median progression-free survival was 544 days and median overall survival was 1,047 days, which the authors considered promising for this hard-to-treat subtype.

• A separate retrospective series in 19 patients with refractory ovarian cancer of mixed histologies compared chemotherapy with and without itraconazole.

• In that broader refractory group, median progression-free survival was 103 vs 53 days and median overall survival was 642 vs 139 days in favour of the itraconazole group.

Practical interpretation

This is not definitive evidence. These were small, non-randomised, single-institution reports. Still, the size of the reported benefit in refractory settings is strong enough to keep ovarian cancer as one of the more important clinical-interest pages in the itraconazole topic.

Any use remains experimental and off-label, with the usual need to consider drug interactions, toxicity, and trial options first.

References

Impact of combination chemotherapy with itraconazole on survival for patients with recurrent or persistent ovarian clear cell carcinoma
https://pubmed.ncbi.nlm.nih.gov/24692739/

Impact of combination chemotherapy with itraconazole on survival of patients with refractory ovarian cancer
https://pubmed.ncbi.nlm.nih.gov/24778064/

Repurposing itraconazole as an anticancer agent
https://pmc.ncbi.nlm.nih.gov/articles/PMC5529765/

Repurposing Drugs in Oncology (ReDO)—itraconazole as an anti-cancer agent
https://ecancer.org/en/journal/article/521-repurposing-drugs-in-oncology-redo-itraconazole-as-an-anti-cancer-agent