{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:30:03Z","timestamp":1760059803304,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dalim Biotech","award":["RS-2024-00360954"],"award-info":[{"award-number":["RS-2024-00360954"]}]},{"name":"National Cancer Center of the Republic of Korea","award":["RS-2024-00360954"],"award-info":[{"award-number":["RS-2024-00360954"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: The effects of combining chemotherapy with hormonal therapy based on hormone receptor (HR) expression in epithelial ovarian, fallopian tube, or primary peritoneal (EOC) remain unclear. This study evaluated the efficacy and safety of physician-chosen chemotherapy combined with hormonal therapy in patients with heavily pretreated advanced EOC, stratified by HR expression. Methods: This phase II, multicenter, pilot study included patients with heavily pretreated advanced EOC, allocated to estrogen receptor (ER)-dominant or progesterone receptor (PR)-dominant arms. Patients in the ER-dominant arm received tamoxifen plus physician-selected chemotherapy, while those in the PR-dominant arm received megestrol acetate (MA) plus chemotherapy. The primary outcome was the best objective response rate (ORR) for six months, assessed using an optimal two-stage Simon design. Results: Among 33 ER-dominant patients with high-grade serous carcinoma (HGSC), the six-month best ORR was 27.3% (3% complete response, 24.2% partial response). The six-month ORR and clinical benefit rate (CBR) were 18.8% and 37.5%, respectively, with 62.5% experiencing progressive disease (PD). Among three PR-dominant patients (two clear cell carcinoma and one HGSC), the six-month best ORR was 0%. The six-month ORR and CBR were also 0%, and all experienced PD within six months. No unacceptable toxicity related to tamoxifen or MA was encountered. Conclusions: In heavily pretreated advanced HGSC patients with ER-dominant expression, chemotherapy combined with tamoxifen showed encouraging clinical activity with favorable safety. While limited by the study design, these findings suggest a potential role for tailored hormonal therapy combined with chemotherapy based on HR expression in heavily pretreated advanced EOC. Clinical Trial Registration: KCT0004571<\/jats:p>","DOI":"10.3390\/cancers17142320","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T07:54:23Z","timestamp":1752479663000},"page":"2320","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Chemotherapy Combined with Hormonal Therapy in Heavily Pretreated Advanced Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer (ELSA\/KGOG3049): A Multicenter Pilot Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Kidong","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chel Hun","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon- ro, Gangnam-gu, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang-Yoon","family":"Park","sequence":"additional","affiliation":[{"name":"Center for Gynecologic Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1937-3611","authenticated-orcid":false,"given":"Min Kyu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Changwon Hospital, Sungkyunkwan University of Medicine, 158, Paryong-ro, Masanhoewon-gu, Changwon-si 51353, Gyeongsangnam-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9005-7796","authenticated-orcid":false,"given":"Keun Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul St. Mary\u2019s Hospital, The Catholic University of Korea, 222 Banpo-daero, Seochogu, Seoul 06591, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9446-1059","authenticated-orcid":false,"given":"Eun-Ju","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Chung-Ang University School of Medicine, Chung-Ang University Hospital, 102 Heukseokro, Dongjak-gu, Seoul 06973, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8964-7158","authenticated-orcid":false,"given":"Myong Cheol","family":"Lim","sequence":"additional","affiliation":[{"name":"Center for Gynecologic Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Han","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hallym University Sacred Heart Hospital, University of Hallym College of Medicine, 22 Gwanpyeong-ro, 170 beon-gil, Dongan-gu, Anyang-si 14068, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5279-4584","authenticated-orcid":false,"given":"Min Sun","family":"Kyung","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Hallym University Dongtan Sacred Heart Hospital, University of Hallym College of Medicine, 7 Keunjaebong-gil, Hwasung-si 18450, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae Hong","family":"No","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Hoon","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Bundang-gu, Seongnam-si 13620, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6110-4909","authenticated-orcid":false,"given":"Jeong-Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University College of Medicine, 81 Irwon- ro, Gangnam-gu, Seoul 06351, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangjeong","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Pathology, Korea University Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1036-3828","authenticated-orcid":false,"given":"Banghyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Inha University Hospital, Inha University College of Medicine, 27 Inhang-ro, Sinheung-dong, Jung-gu, Incheon 22332, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/S0140-6736(09)61338-6","article-title":"Ovarian cancer","volume":"374","author":"Hennessy","year":"2009","journal-title":"Lancet"},{"key":"ref_2","unstructured":"Foley, O.W., Rauh-Hain, J.A., and Del Carmen, M.G. 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