Olaparib maintenance therapy for recurrent adult granulosa cell tumors: A case report

Poly (ADP-ribose) polymerase inhibitors (PARPi) are now available for advanced or recurrent epithelial ovarian cancer after platinum-based chemotherapy; however, there is little known concerning the use of PARPi for adult granulosa cell tumors (AGCT). A 49-year-old woman, who previously had primary debulking surgery and a second surgery for a first intraperitoneal recurrence, received a surgery for a second intraperitoneal recurrence of AGCT. Although she received paclitaxel-carboplatin combination chemotherapy and a combination of bleomycin, etoposide, and cisplatin after the surgeries for the first and the second recurrences, respectively, the risk of a third recurrence was considered very high due to microscopic peritoneal dissemination. Olaparib administration was initiated based on a FANCA mutation, which results in homologous recombination deficiency. The patient has been recurrence-free for over 4 years since the initiation of olaparib. This case highlights the possibility of using olaparib for AGCT with a homologous recombination gene mutation.