Which experimental medications are being investigated for the treatment of granulosa cell tumors (GCTs) of the ovaries?

Updated: Aug 30, 2018
  • Author: David C Starks, MD, MPH; Chief Editor: Warner K Huh, MD  more...
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Experimental medications

There has been increasing interest in the use of antiangiogenic therapy in GCTs due to accumulating evidence on the role of angiogenesis in this class of tumors. Case reports and 1 case series show potentially promising results, with 1 patient having a complete and 2 patients having partial responses out of 8 patients with GCTs treated with bevacizumab at MD Anderson Cancer Center. [25]

Several recent case reports have raised the possibility of the use of hormonal therapy in the management of recurrent GCTs. Responses to medroxyprogesterone acetate, GnRH agonists, and megestrol (Megace) [26] have all been reported in a small number of patients with progressive disease not responsive to chemotherapy.

Treatment of recurrent GCTs with leuprolide acetate has been described but exhibited only marginal success in a small number of patients. Several recent reports have documented the use of the aromatase inhibitors, which inhibit the conversion of androstenedione to estrone, in the management of patients who previously received surgery and chemotherapy. To date, there are less than 10 patients published in the literature who received aromatase inhibitors as part of their treatment strategy. Several patients have shown durable responses and 1 patient treated after surgical resection of a second recurrence remained disease free for at least 54 months. [27] Another case report used an aromatase inhibitor as a rescue therapy for tamoxifen-refractory disease. [28] Although interesting, the role of aromatase inhibitors in GCTs remains investigational.

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