cis-platinum/vinblastine/bleomycin combination chemotherapy in advanced or recurrent granulosa cell tumors of the ovary.

Seven consecutive patients with advanced/recurrent granulosa cell tumors were treated with PVB (cis-platinum, 20 mg/m2, Days 1-5; vinblastine, 6 mg/m2, Days 1 and 2; and bleomycin, 18 mg/m2, Days 2, 9, and 16). The median age at the start of PVB treatment was 53 years (15-57); three patients had stage III disease and four presented with abdominal recurrences. Prior to PVB, all but one patient underwent surgical treatment, and in six patients gross residual disease was documented. No patient received prior chemotherapy or radiotherapy. The median number of PVB cycles was 5. Three complete (one pathologically documented) and one partial response were observed, for an over-all response rate of 66%. Two complete responders were alive without evidence of disease 7 and 26 months from the start of treatment; the remaining patient relapsed at 15 months. Two patients progressed during treatment, and one died because of sepsis in agranulocytosis. Signs of peripheral neurotoxicity were documented in three patients. The present data confirm the therapeutic activity of the PVB regimen in advanced/recurrent granulosa cell tumors, but the cost/benefit ratio should be clearly assessed.