Efficacy of cyclin-dependent kinase 4/6 inhibitors in combination with hormonal therapy in patients with recurrent granulosa cell tumor of the ovary: A case series

• Published in: Gynecologic oncology reports 2023-12, Vol.50, p.101297, Article 101297
• Main Authors: Albright, Benjamin B., Shuey, Stephanie, Alvarez-Secord, Angeles, Havrilesky, Laura J., Berchuck, Andrew, Previs, Rebecca A.
• Format: Article
• Language: English
• Subjects: Cyclin-dependent kinase inhibitors; Granulosa cell tumor; Inhibins; Ovarian cancer; Sex-cord stromal tumor; Survey
• ISSN: 2352-5789; 2352-5789
• DOI: 10.1016/j.gore.2023.101297

•Case series of 7 patients with heavily pretreated adult-type granulosa cell tumors of the ovary.•Included patients were treated with cyclin dependent kinase 4/6 inhibitors in combination with antiestrogen therapy.•Partial response was observed in 3 patients and stable disease confirmed in 2 patients.•At the time of data cutoff, 3 patients remained on therapy and 5 patients were alive, with medians not yet reached.•The most frequent toxicity was neutropenia; toxicity led to dose reduction in 3 patients and discontinuation in 1 patient. Cyclin-dependent kinase inhibitors are approved in combination with hormonal therapy for treatment of hormone receptor expressing breast cancers. Activity in hormone receptor expressing gynecologic cancers has been postulated. Granulosa cell tumor of the ovary is one such cancer, which is relatively resistant to traditional cytotoxic chemotherapy. We report a case series of 7 heavily pre-treated patients with recurrent granulosa cell tumor of the ovary with a cyclin-dependent kinase inhibitor in combination with hormonal therapy, with 3 patients demonstrating partial response and 2 with stable disease. As of the data cutoff, 3 patients remained on treatment and 5 were alive, with true medians for duration of treatment and overall survival not reached (medians at data cutoff of 64 weeks and 62 months respectively). The treatment was generally well tolerated, with 1 patient choosing to discontinue treatment due to grade 3 fatigue. This regimen represents a possible option in the treatment of granulosa cell tumor of the ovary, warranting further prospective study for this unmet need in this indolent disease which often requires many lines of treatment.