Cisplatin (P), vinblastine (V), and bleomycin (B) combination chemotherapy in recurrent or advanced granulosa cell tumor of the ovary (GCTO): An eortc gynecology cancer cooperative group study

Pecorelli, Sërgio; Wagener, P.; Bonazzi, Cristina; Huinink, W. ten Bokkel; Colombo, N.; Favalli, G.; Kobierska, A; Ploch, E; Veenhof, Chn; Willemze, R.; Rotmensz, Nicole; Vermorken, J. B.

doi:10.1016/0090-8258(89)90927-x

Cited by 5 publications

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“…Few reports about monotherapy have been published (Tables 3, 4). Following the evolution in treatment of ovarian nonepithelial tumors and testicular tumors, a three-drug association containing bleomycin, vinblastine, and cisplatin regimen was tested after the 1980s with promising results: 9 patients achieved a response out of 11 evaluable patients in Colombo's series (6 CR 1 3 PR) (4) , 23 patients achieved a response out of 38 evaluable in the Pecorelli's series (12 CR 1 11 PR) (25) , 4 patients achieved a response out of 5 evaluable in the Savage's series (1 CR 1 3 PR) (26) , 3 patients out of 4 in our personal series (3 CR) (1) , and 4 patients achieved a response out of 7 evaluable in the Zambetti's series (3 CR 1 1 PR) (24) , which means a total of 43 (Table 4). Studies performed in the 1990s in germ cell tumors have shown that etoposide was better (less toxicity with higher response rate) than vinblastine in the treatment of germ cell tumors (28) .…”

Section: Discussionmentioning

confidence: 99%

Combination of bleomycin, etoposide, and cisplatin for the treatment of advanced ovarian granulosa cell tumors

Pautier

Gutierrez-Bonnaire

Rey

et al. 2008

Int J Gynecol Cancer

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The objective is to investigate the activity and toxicity of bleomycin, etoposide, and cisplatin (BEP) regimen in ovarian granulosa cell tumors (OGCTs). Twenty consecutive patients with initial metastatic (5 patients) or recurrent (15 patients) OGCT were treated; BEP regimen: B: 30 mg intravenously or intramurally on days 1, 8, and 15; E: 100 mg/m2/day on days 1-5; and P: 20 mg/m2/day on days 1-5. Median age: 42 years (range: 17-60); median follow-up: 45 months (range: 3-112). The overall response rate is 90% (nine clinical complete response [CR], nine clinical partial response) with a median duration of 24 months (range: 4-77). A second-look laparotomy performed in 11 patients showed a pathologic CR in 7 cases and microscopic disease in 1 case. Seven patients remain free of disease (at 4-84 months); 11 patients relapsed (median: 24 months, range: 13-58), 12 patients are still alive, and 9 patients are without disease (2 patients in second CR). At 4 years, overall survival and event-free survival are respectively 58% and 30%. Toxicity is evaluable for 19 patients (48 cycles). A grade 4 neutropenia occurred in 15% of cycles (in seven patients) with a febrile neutropenia in four patients. Five patients experienced a low bleomycin pulmonary toxicity. BEP regimen appears to be an active regimen for OGCT in first-line chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Combination of bleomycin, etoposide, and cisplatin for the treatment of advanced ovarian granulosa cell tumors

Pautier

Gutierrez-Bonnaire

Rey

et al. 2008

Int J Gynecol Cancer

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“…Some authors have described prolonged complete responses with cisplatin‐based first line multiagent CT in advanced or recurrent disease. With the PVB protocol (cisplatin, vinblastine, bleomycin), Pecorelli ( 23 ) obtained 6 complete response (CR) in 13 patients, Zambetti ( 24 ) 2 CR in seven, and Colombo ( 25 ) 5 CR in 11 patients. With the CAP protocol (cisplatin, adriamycin, cyclophosphamide), Müntz ( 26 ) , reported in a literature review, nine prolonged CR in 36 patients.…”

Section: Discussionmentioning

confidence: 99%

Adult granulosa-cell tumor of the ovary: a retrospective study of 45 cases

Pautier

Lhommé

Culine

et al. 1997

Int J Gynecol Cancer

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This study describes 45 cases of adult granulosa-cell tumors seen in our institution between 1976 and 1993. The median age was 46.5 years (12-77) and 18 women were postmenopausal. Vaginal bleeding was present in one-third of cases; other complaints were abdominal pain (28%) and the presence of a pelvic mass (47%). The tumor size was variable (<3 cm to 30 cm, median 11.5 cm). FIGO stages were: stage I: 30 (73%) (19 Ia, seven Ic, four I unknown); stage II: seven (17%) (two IIa, five IIC); stage III: three (7%) (one IIIb, two IIIc). Two adenocarcinomas and 13 cases of hyperplasia were found in 25 endometrial samples available. The initial therapy for all the cases was surgery, consisting in 34 patients of hysterectomy, bilateral salpingo-oophorectomy, +/- tumor resection. Sixteen patients received adjuvant therapy as well: chemotherapy (CT) alone for 12, radiotherapy (RT) alone for two, and CT + RT for two patients. Among the 39 patients who achieved a complete response after initial therapy, 15 patients have relapsed (pelvic recurrences) (38.5%) including six stage Ia (three received only conservative surgery). All the recurrent tumors were resected and 14/15 had CT (13/14 with cisplatin). The overall survival rate was 77.2% at 5 years, 66.5% at 10 years, and 41.2% at 20 years. A statistically significant difference was found between the survival of patients with stage Ia disease (75% at 10 and 15 years) and that of other patients (60% at 10 years, and <50% at 15 years). Serum estradiol and serum inhibin were measured in some patients and the results are described.

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“…In another series, 13 patients with advanced or recurrent granulosa cell tumors were treated with PVB. 88 The reported CR was 54%, PR 39%, and overall RR 93%. These series established PVB as an active regimen in the treatment of advanced and/or recurrent granulosa cell tumors.…”

Section: Chemotherapymentioning

confidence: 99%

“…21,74,75,[78][79][80] The next reports appeared on the use of combination chemotherapy consisting of doxorubicin and bleomycin 79 and dactinomycin, cyclophosphamide, and 5-fluorouracil. 21 The introduction of cisplatin has led to different combinations such as cisplatin and doxorubicin, 81 CAP (cyclophosphamide, doxorubicin, and cisplatin), 13,39,[81][82][83][84][85] PVB (cisplatin, vinblastine, and bleomycin), 13,[86][87][88] and BEP 86,87 (Table 2). Ten patients with advanced or recurrent granulosa cell tumors were treated with CAP.…”

Section: Chemotherapymentioning

confidence: 99%

Granulosa Cell Tumor of the Ovary: Tumor Review

et al. 2008

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Granulosa cell tumors of the ovary are rare neoplasms that originate from sex-cord stromal cells. The long natural history of granulosa cell tumors and their tendency to recur years after the initial diagnosis are the most prominent of their characteristics. The secretion of estradiol is the reason for signs at presentation such as vaginal bleeding and precocious puberty. Abdominal pain and hemoperitoneum, which occasionally can occur, are attributable to tumor rupture. The most common finding in pelvic examination is a tumor mass, which is subsequently confirmed with imaging techniques. Surgery is the mainstay of initial management for histological diagnosis, appropriate staging, and debulking. A more conservative unilateral salpingo-oophorectomy is indicated in patients with stage I disease and patients of reproductive age. Total abdominal hysterectomy with bilateral salpingo-oophorectomy is the appropriate surgical treatment for postmenopausal women and those with more advanced disease. The stage of disease is the most important prognostic factor associated with the risk of relapse. There are no clear conclusions regarding the role of postoperative chemotherapy or radiotherapy in stage I disease and in those with completely resected tumor. The use of adjuvant chemotherapy or radiotherapy has sometimes been associated with prolonged disease-free survival and possibly overall survival. Chemotherapy is the treatment of choice for patients with advanced, recurrent, or metastatic disease, and BEP (bleomycin, etoposide, and cisplatin) is the preferred regimen. Although the overall rate of response to treatment is high, the impact of treatment on disease-free or overall survival is unknown. Prolonged surveillance is mandatory because tumors tend to recur years after the initial diagnosis.

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Cisplatin (P), vinblastine (V), and bleomycin (B) combination chemotherapy in recurrent or advanced granulosa cell tumor of the ovary (GCTO): An eortc gynecology cancer cooperative group study

Cited by 5 publications

References 0 publications

Combination of bleomycin, etoposide, and cisplatin for the treatment of advanced ovarian granulosa cell tumors

Combination of bleomycin, etoposide, and cisplatin for the treatment of advanced ovarian granulosa cell tumors

Adult granulosa-cell tumor of the ovary: a retrospective study of 45 cases

Granulosa Cell Tumor of the Ovary: Tumor Review

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