Tuesday, January 11, 2022

Malignant Ovarian Germ Cell Tumors

This article appeared in Ocrahope.org

Malignant ovarian germ cell tumors represent less than 5% of all ovarian cancers, and occur primarily in girls and young women in their 20s and 30s. Prior to the 1970s, this type of tumor had a very high mortality rate, but since the introduction of contemporary BEP chemotherapy (bleomycin, etoposide, and cisplatin; a combination often used to treat testicular cancer), the cure rate is 95%. Because this type often affects only one ovary, fertility-sparing surgery is sometimes feasible.

  • A low risk international study has enrolled children and adults with Stage 1A and 1B ovarian germ cell tumors that are confined to the ovaries. Patients in the study undergo observation following primary surgery, and receive chemotherapy only if they develop a recurrence. The concept is to try to avoid chemotherapy altogether in patients with very early stage disease. This trial is ongoing, with results expected in about 5 years.
  • The same study, this one for patients ages up to 25 years old with Stage 1C-111 malignant ovarian germ cell ovarian cancer, compares the current standard BEP chemotherapy with a bleomycin, etoposide, carboplatin chemotherapy. Carboplatin is thought to be less toxic than cisplatin, and if results of the trial are positive, it will represent a major advancement in lessening short and long-term toxicity. 


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