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Debate 24B - What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?

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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

Advanced malignant ovarian germ cell tumors (MOGCT), like their testicular counterparts, are exquisitely sensitive to platinum- and etoposide-based chemotherapy. More than 40 years ago Einhorn and colleagues discovered that bleomycin added to this combination was an effective treatment. The resulting five-day bleomycin etoposide and cisplatin (BEP) chemotherapy given three-weekly for three to four cycles depending on disease extent was internationally adopted. Subsequently, many other regimens have been developed attempting to reduce toxicity and/or improve efficacy. However, no randomized controlled trial data exists to demonstrate that any of these are superior to BEP chemotherapy. Moreover, as MOGCT differs from testicular disease in that relapses after primary chemotherapy have much lower survival rates, de-escalation of primary treatment is to be discouraged. Consequently, there is no debate as BEP remains the current standard of care for women presenting with advanced MOGCT.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Hanna, N, et al. Testicular cancer: a reflection on 50 years of discovery. J Clin Oncol 2014;32(28):30853092Google Scholar
Newton, C, et al. A multicentre retrospective cohort study of ovarian germ cell tumours: evidence for chemotherapy de-escalation and alignment of paediatric and adult practice. Eur J Cancer 2019;113:1927.Google Scholar
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Ray-Coquard, I, et al. ESMO Guidelines Committee. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2018;29(Suppl. 4):iv1–iv18CrossRefGoogle ScholarPubMed
Veneris, JT, et al. Contemporary management of ovarian germ cell tumors and remaining controversies. Gynecol Oncol 2020;158(2):467475.CrossRefGoogle ScholarPubMed

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