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Debate 25B - What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?

Carboplatin/Paclitaxel

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

By
Dib Sassine  and
Chrissy Liu
Edited by
Dennis S. Chi ,
Nisha Lakhi  and
Nicoletta Colombo
Dennis S. Chi
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York
Nisha Lakhi
Affiliation:
Richmond University Medical Center, Staten Island
Nicoletta Colombo
Affiliation:
University of Milan-Bicocca
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Summary

Surgery remains the cornerstone of initial treatment for granulosa cell tumors (GCTs). Postoperative cytotoxic chemotherapy has often been given in attempt to improve cure rate with bleomycin, etoposide, and cisplatin (BEP) being the most widely used postoperative treatment. However, because taxanes are active drugs in GCTs, carboplatin plus paclitaxel (PC) is also considered as a reasonable alternative. In the following article, we support the use of BEP based on (i) bleomycin and etoposide as single agents are the most efficient drugs reported in literature, (ii) carboplatin has never shown equivalence to cisplatin in GCTs, (iii) BEP is the regimen associated with the strongest level of evidence, and (iv) comparison between BEP and PC failed to demonstrate a benefit in favor of PC.

Type
Chapter
Information
50 Big Debates in Gynecologic Oncology , pp. 149 - 151
Publisher: Cambridge University Press
Print publication year: 2023

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References

DiSaia, PJ, et al. Clinical Gynecologic Oncology (9th edn.). London: Elsevier, 2018.Google Scholar
Network NCC. NCCN Guidelines Version 1.2022 Ovarian Cancer. Published 2022.Google Scholar
Young, RH. Ovarian sex cord-stromal tumours and their mimics. Pathology 2018;50(1):5–15.CrossRefGoogle ScholarPubMed
Homesley, HD, et al. Bleomycin, etoposide, and cisplatin combination therapy of ovarian granulosa cell tumors and other stromal malignancies: a gynecologic oncology group study. Gynecol Oncol 1999;72(2):131–137.CrossRefGoogle ScholarPubMed
Gershenson, DM, et al. Treatment of poor-prognosis sex cord-stromal tumors of the ovary with the combination of bleomycin, etoposide, and cisplatin. Obstet Gynecol 1996;87(4):527–531.CrossRefGoogle ScholarPubMed
Brown, J, et al. The activity of taxanes in the treatment of sex cord-stromal ovarian tumors. J Clin Oncol 2004;22(17):3517–3523.CrossRefGoogle ScholarPubMed
Brown, JMA, et al. 125 Results of a randomized phase II trial of paclitaxel and carboplatin versus bleomycin, etoposide and cisplatin for newly diagnosed and recurrent chemonaive stromal ovarian tumors. Int J Gynecol Cancer 2020;30:A56.Google Scholar

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