Targeted therapies in the treatment of ovarian granulosa cell tumours – a monocentric case series

Background Granulosa cell tumour (GCT) patients diagnosed for advanced, recurrent or metastatic disease are routinely treated with chemotherapies (CHTs). In spite of being widely used, efficacy of CHT in terms of improving disease outcome seems to be rather limited. As GCTs are more and more recognized to be genetically heterogenous, we analysed the role of targeted therapies in treatment of GCTs.

Patients and methods This retrospective registry was run at Nationales Centrum für Tumorerkrankungen/Universitätsfrauenklinik Heidelberg. Clinicopathological and follow-up data of 40 patients, initially diagnosed between 1992–2016, were analysed.

Results At primary diagnosis most patients (73%; 29/40) solely underwent surgical tumour resection and 11 patients (28%; 11/40) had additional adjuvant treatment. Among adjuvant treated patients nine received CHT and two had endocrine treatment (ET).

In patients presenting with relapsed, unresectable or metastatic disease (n = 23) the median number of relapses was 4.5 (range: 2–10). At least one targeted therapy line was administered to 8 patients (35%; 8/23). Median duration of an ET line was 10.7 months (range: 1.9–48 months) and median number of ET lines per patient was 2 (range: 1–7). ETs most commonly applied were tamoxifen, aromatase inhibitors and GnRH-analogues (each n=6). Only one patient received targeted therapies other than ET as recommended by Molecularly-Aided-Stratification-for-Tumor-Eradication (MASTER-Study).

Conclusion ET plays a role in treatment of GCTs, especially in relapsed and metastatic setting. Targeted therapies other than endocrine ones are still under-represented, hence, inclusion of GCT patients into precision oncology programs and biomarker based early phase clinical trials should be strengthened.

Publication History

Article published online:
11 October 2022