Ovarian Granulosa Cell Tumor: New Insights into the Clinical Challenge of Late Relapse
Abstract
Adult granulosa cell tumor (AGCT) is a distinctive subtype of ovarian cancer affecting menopausal or post-menopausal women. Most cases of AGCT (~90%) are diagnosed when the tumors are confined to the ovary (Stage I), and the mainstay of therapy is surgical resection. The 5-year survival is greater than 90% for patients with Stage I AGCT but is significantly worse for patients with more advanced disease. The ostensibly favorable 5-year survival for individuals with Stage I AGCT belies the major clinical problem of late relapse; many women with Stage I AGCT suffer relapses 6-8 years after their diagnosis. There are limited treatment options for patients with recurrent AGCT, and the majority will die from complications of the disease. Given the propensity for AGCT to relapse years after the initial diagnosis, more effective therapies are needed. Certain hormones are known to impact the growth and survival of AGCT cells in a Petri dish, raising the possibility that hormone modulation therapy could be used as an adjunct to prevent relapse in patients. The objective of this proposal is to explore whether patients at risk, such as those with Stage I AGCT who have undergone surgical resection, could benefit from hormonal modulation therapy. Our approach combines a novel mouse model of AGCT with a population-based study of patients with AGCT. The research strategy leverages a robust clinical database of Finnish patients with AGCT. This database is coupled to patient blood and tumor specimens. There is a dearth of published longitudinal clinical data for AGCT, and our study population is larger than any reported in the medical literature. The proposed research is relevant to the vision and mission of the Ovarian Cancer Research Program insofar as it will confront prevailing views and will provide clinically actionable information about the benefits or risks of hormone therapy in patients with AGCT. The knowledge gleaned from this research should facilitate the design of future clinical trials and enhance the quality of life for patients with AGCT.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610188
Entities
People
- David M Wilson
Organizations
- United States Army
- Washington University in St. Louis