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Management of recurrent and persistent malignant ovarian germ cell tumors: a narrative review
  1. Dimitrios Nasioudis1 and
  2. Farzana Dinesh Pashankar2
    1. 1 Division of Gynecologic Oncology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. 2 Division of Pediatric Hematology & Oncology, Yale University, New Haven, Connecticut, USA
    1. Correspondence to Dr Dimitrios Nasioudis, Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA; dimitrios.nasioudis{at}pennmedicine.upenn.edu

    Abstract

    Approximately 10% of patients with malignant ovarian germ cell tumors will experience a tumor relapse. Given the rarity of malignant ovarian germ cell tumors, management of these patients is challenging. Secondary cytoreductive surgery can be considered for carefully selected patients with a goal to achieve complete gross or optimal resection. For patients with platinum sensitive disease who have already received platinum-based chemotherapy, standard dose chemotherapy with paclitaxel/ifosfamide/cisplatin or vinblastine/ifosfamide/cisplatin can be considered. High-dose chemotherapy protocols at specialized centers should be explored even for patients with platinum-resistant disease; however, optimal timing is under investigation. A subset of patients with malignant ovarian germ cell tumors harbors potentially actionable genomic alterations. Further research is required to identify novel therapeutic approaches for these patients.

    • Ovarian Cancer

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    Footnotes

    • Contributors Both authors contributed equally. DN, FP: conception, drafting/final editing, DN: guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.