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

Bleomycin, Etoposide, and Cisplatinum (BEP)

from Section III - Ovarian Cancer

Published online by Cambridge University Press:  20 July 2023

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

The notion that BEP is the optimal chemotherapy regimen for all ovarian germ cell tumors (OGCT) is flawed as there are a number of equally effective and potentially less toxic treatment regimens. OGCTs are highly curable and the focus over recent years has been on minimizing toxicity of treatment and in particular late effects. There has been much effort in de-escalating treatment particularly in patients with advanced stage dysgerminomas with excellent outcomes achieved with carboplatin either alone or in combination. Treatment options for patients with good prognosis, advanced non-dysgerminomatous germ cell tumors include four cycles of etoposide and cisplatin instead of three cycles of BEP. An effective alternative is to substitute ifosfamide for bleomycin and to use three cycles only. In the minority of patients with advanced OGCTs who have adverse prognostic factors, relapse is still high with BEP alone and they should be treated in expert centers with access to clinical trials.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

ESMO. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018;29:iv1–iv18.Google Scholar
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;87:527531.CrossRefGoogle ScholarPubMed
Zambetti, M, et al. cis-platinum/vinblastine/bleomycin combination chemotherapy in advanced or recurrent granulosa cell tumors of the ovary. Gynecol Oncol 1990;36(3):317320.CrossRefGoogle ScholarPubMed
Brown, J, et al. The activity of taxanes compared with bleomycin, etoposide, and cisplatin in the treatment of sex cord-stromal ovarian tumors. Gynecol Oncol 2005;97:489496.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;72:131137.CrossRefGoogle ScholarPubMed
Pautier, P, et al. Combination of bleomycin, etoposide, and cisplatin for the treatment of advanced ovarian granulosa cell tumors. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 2008;18:446452.CrossRefGoogle ScholarPubMed
Ray-Coquard, I, et al. Management of rare ovarian cancers: the experience of the French website «Observatory for rare malignant tumours of the ovaries» by the GINECO group: Interim analysis of the first 100 patients. Gynecol Oncol 2010;119:5359.CrossRefGoogle ScholarPubMed
Brown, J, 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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