We conducted a retrospective review of all patients seen at our institution from February 2004 to October 2008 who received bevacizumab for ovarian sex cord-stromal tumors. We performed immunohistochemical staining for vascular endothelial growth factor (VEGF) and CD31 when tissue was available; microvessel density was measured based on CD31 staining. Clinical data were abstracted from a chart review.
We identified 8 patients who were treated with bevacizumab; 7 had adult granulosa cell tumors and one had a juvenile granulosa cell tumor. All patients had recurrent disease and had been previously treated with cytotoxic chemotherapy (median 3.5 regimens; range, 1–6). One patient had a complete clinical response to bevacizumab therapy, 2 patients had a partial response, 2 patients had stable disease, and 3 patients' disease progressed, yielding a response rate of 38 % and a clinical benefit rate of 63 % . The median progression-free survival was 7.2 months and overall survival was not reached at a median follow-up of 23.6 months after initiating bevacizumab.
VEGF overexpression and microvessel density were associated with poor outcome but sample size was too small to calculate statistical significance.
Anti-VEGF therapy is highly effective in patients with granulosa cell tumors. Based on our observations, a prospective trial has been initiated using single-agent bevacizumab in patients with recurrent ovarian sex cord-stromal tumors.