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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

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.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

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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):527531.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):35173523.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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