Germ cell tumours are a rare type of ovarian cancer which come from the germ cells in the ovary. Germ cells are the cells which have the potential to go on to form the eggs which are fertilised when an embryo forms. For more information on germ cell tumours check out the germ cell tumour document on thisisGO.ie.
In this study the researchers wanted to find out if giving this combination of 3 chemotherapy drugs was an effective way of preventing the cancer from coming back after surgery had completely removed all traces of the cancer.Once surgery was complete patients were given 3 cycles of these 3 chemotherapy drugs at 3 week intervals. Surgery involved removal of one or both ovaries with or without removal of the uterus. 117 patients were enrolled on the study with data available for 93 of them. Of these, 89 remained free of germ cell cancer of the ovary at the end of the study period. The patients were followed up for an average of more than 3 years.
The treatment was associated with some side effects such as myelosuppression (reduced white cell and platelet blood counts), mucositis (mouth ulceration and pain) and fever due to infection from low white blood cells. 2 patients developed other cancers in the follow up period – 1 leukaemia believed to be due to the drug etoposide and another lymphoma which was thought to be unrelated to treatment.
Approximately half of the patients on the study had a second surgery to see if any cancer had come back after they finished their chemotherapy. In all but 4 of these patients, there was no evidence of germ cell cancer.
There are a few interesting things that were decided on because of this study. This regimen seemed to be more effective at preventing recurrence of germ cell ovarian cancer after all the tumour had been removed with surgery than the types of treatment that were used previous to this study with a shorter length of treatment and less side effects. It also shows that it is reasonable and safe to just remove one ovary in the setting of germ cell ovarian cancer and to leave the other ovary (if it is not involved) and the fallopian tube and uterus so the patient may be able to consider pregnancy in future if they wish as several patients in the study had just one ovary removed and remained free of cancer after chemotherapy.
Chemotherapy with Bleomycin Etoposide and CisPlatin is effective for reducing the risk of germ cell cancer of the ovary recurring.