Re: Conditional Survival of Patients with Metastatic Testicular Germ Cell Tumors Treated with First-Line Curative Therapy

2017 ◽  
Vol 197 (1) ◽  
pp. 158-158
Author(s):  
Jerome P. Richie
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Conditional Survival ◽  
Testicular Germ Cell Tumors ◽  
First Line ◽  
Testicular Germ Cell ◽  
Curative Therapy

Conditional Survival of Patients With Metastatic Testicular Germ Cell Tumors Treated With First-Line Curative Therapy

2016 ◽  
Vol 34 (7) ◽  
pp. 714-720 ◽  
Author(s):  
Jenny J. Ko ◽  
Brandon Bernard ◽  
Ben Tran ◽  
Haocheng Li ◽  
Tehmina Asif ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Germ Cell ◽  
Risk Group ◽  
Cell Cancer ◽  
Collaborative Group ◽  
Conditional Survival ◽  
First Line ◽  
Testicular Germ Cell ◽  
Curative Therapy ◽  
Disease Free

Purpose The International Germ Cell Cancer Collaborative Group (IGCCCG) criteria prognosticate survival outcomes in metastatic testicular germ cell tumor (MT-GCT), but how the initial risk changes over time for those who survived since curative treatment is unknown. Patients and Methods We assessed patients eligible for first-line therapy for MT-GCT at five tertiary cancer centers from 1990 to 2012 for 2-year conditional overall survival (COS) and conditional disease-free survival (CDFS), defined as the probability of surviving, or surviving and being disease free, respectively, for an additional 2 years at a given time point since the initial diagnosis. Results For all patients (N = 942), 2-year COS increased from 92% (95% CI, 91% to 94%) at 0 months to 98% (95% CI, 97% to 99%), and 2-year CDFS increased from 83% (95% CI, 81% to 86%) at baseline to 98% (95% CI, 97% to 99%) at 24 months after diagnosis. Two-year COS improved by 2% (97% at 0 months, 99% at 24 months) in the IGCCCG favorable-risk group, by 5% (94% at 0 months, 99% at 24 months) in the intermediate-risk group, and by 22% (71% at 0 months to 93% at 24 months) in the poor-risk group. Two-year CDFS improved significantly at 12 months for each risk group (favorable, 91% baseline v 95% at 12 months; intermediate, 84% v 95%; poor, 55% v 85%). Baseline IGCCCG risk stratification was not associated with long-term COS or CDFS for patients who survived to greater than 2 years post therapy. No significant differences in COS and CDFS were noted between seminoma and nonseminoma; patients ≥ 40 years old had inferior 2-year COS from 0 to 12 months, but no differences were noted at 18 months. Conclusion Our data suggest that the concept of conditional survival applies to patients with MT-GCT treated with curative therapy. Patients with MT-GCT who survived and remained disease free more than 2 years after the diagnosis had an excellent chance of staying alive and disease free in additional subsequent years, regardless of the initial IGCCCG risk stratification.

scholarly journals The effect of primary granulocyte-colony stimulating factor prophylaxis on incidence of febrile neutropenia in patients with testicular germ cell tumors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17056-e17056
Author(s):  
Nikola Hapakova ◽  
Michal Chovanec ◽  
Katarina Rejlekova ◽  
Katarina Kalavska ◽  
Jana Obertova ◽  
...  
Keyword(s):  
Overall Survival ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
Primary Prophylaxis ◽  
Testicular Germ Cell Tumors ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
First Line ◽  
Testicular Germ Cell ◽  
Stimulating Factor

e17056 Background: Testicular germ cell tumors (GCTs) represent only one percent of all solid tumors; however, they are the most common solid malignancy in men 15-35 years old. Febrile neutropenia (FN) is a grievous complication of chemotherapy, frequently occurring in GCT patients. The aim of this retrospective study was to assess the effect of primary granulocyte-colony stimulating factor (G-CSF) prophylaxis on the incidence of FN in GCT patients. Methods: This study was conducted using the National Cancer Institute medical records database. Patients diagnosed with germ cell tumors treated with first line/adjuvant chemotherapy at the National Cancer Institute, Bratislava, Slovakia from January 2000 to December 2017 were eligible. Starting in January 2006, patients received G-CSF prophylaxis after every cycle of chemotherapy. Results: Out of 393 patients, 265 patients received primary G-CSF prophylaxis and 128 patients did not receive prophylaxis. The majority of patients (69.97%) were treated with bleomycin, etoposide and cisplatin chemotherapy. There were 61 deaths (15.5%) in our study population. 2- and 5-year OS of the study group was 86.8% and 83.1%, respectively. During the study period, 71 patients (18.1%) suffered FN events. Out of 128 patients who did not receive primary prophylaxis, 42 (32.8%) patients suffered FN, while only 29 (10.9%) patients with primary prophylaxis suffered FN ( P = 0.0000001). On subgroup analysis, FN incidence decreased in all groups with primary prophylaxis, except for patients with stage I GCT receiving adjuvant chemotherapy. Patients receiving G-CSF prophylaxis had significantly longer overall survival when compared to patients without prophylaxis. (HR = 0.44, 95% CI 0.26-0.75; P = 0.0009). Conclusions: Primary G-CSF prophylaxis was associated with significantly decreased FN incidence and longer overall survival in patients treated with first line chemotherapy and should be consider in all patients except stage I disease.

Conditional survival of patients with metastatic testicular germ-cell carcinoma (MT-GCT) treated with first-line curative therapy.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e20639-e20639
Author(s):  
Jenny J. Ko ◽  
Tehmina Asif ◽  
Haocheng Li ◽  
Nimira S. Alimohamed ◽  
Thao Phuong Nguyen ◽  
...  
Keyword(s):  
Germ Cell ◽  
Cell Carcinoma ◽  
Conditional Survival ◽  
First Line ◽  
Testicular Germ Cell ◽  
Curative Therapy

First-Line High-Dose Chemotherapy for ’Poor Risk’ Metastatic Non-Seminomatous Testicular Germ Cell Tumors

1998 ◽  
Vol 21 (2) ◽  
pp. 23-25 ◽  
Author(s):  
C. Bokemeyer ◽  
A. Harstrick ◽  
J. Beyer ◽  
B. Metzner ◽  
U. Rüther ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Testicular Germ Cell Tumors ◽  
First Line ◽  
Testicular Germ Cell ◽  
Poor Risk

Conditional survival of patients with metastatic testicular germ-cell tumors (MT-GCT) treated with first-line curative therapy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 472-472
Author(s):  
Jenny J. Ko ◽  
Brandon David Bernard ◽  
Ben Tran ◽  
Haocheng Li ◽  
Tehmina Asif ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Germ Cell ◽  
Risk Group ◽  
Conditional Survival ◽  
First Line ◽  
Testicular Germ Cell ◽  
Curative Therapy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Disease Free

472 Background: The IGCCCG risk stratification prognosticates survival outcomes in metastatic testicular germ cell tumour (MT-GCT), but how the initial risk changes over time for those who survived since curative treatment (conditional survival) is unknown. We evaluated conditional survival in patients with MT-GCT who were eligible for first-line therapy. Methods: We included patients who were eligible for first-line therapy for MT- GCT at 5 tertiary cancer centres from 1990 to 2012. We assessed 2-year (Y) conditional overall (COS) and disease-free survival (CDFS) at a given timepoint, defined as the probability of surviving, or surviving and disease-free, respectively, for an additional 2Y at a given timepoint since the start of first-line treatment. Outcomes were stratified by IGCCCG risk criteria, pathology and age. Results: For all patients (n = 942, favourable 63%/intermediate 19%/poor 16%), median follow-up was 99 months (m) (IQR 56-141); 2YCOS increased from 92% (95% CI 91%–94%) at baseline to 98% (95% CI 97%–99%) at 24m, and 2Y CDFS increased from 83% (95% CI: 81%-86%) at baseline to 98% (95% CI 97%-99%) at 24m after diagnosis. 2YCOS changed little in the IGCCCG favourable and intermediate groups, but in the poor-risk group, improved from 71% (95% CI 64%–78%) at 0m to 93% (95% CI 89%-98%) at 24m. 2Y CDFS for favourable risk group improved significantly at 12m (91% baseline vs. 95% at 18m); intermediate, at 12m (84% baseline vs. 95% at 12m); poor, at 12 m (55% baseline vs. 85% at 12m). Baseline IGCCCG risk stratification was not associated with long-term COS or CDFS for patients who survived to > 2Y post therapy. No significant differences in COS and CDFS were noted between seminoma and non-seminoma, while older patients ( > = 40) had inferior 2Y COS from 0-18m but no differences were noted after 18m. Conclusions: Our data suggest that the concept of conditional survival applies to patients with MT-GCT treated with curative therapy. A poor-risk patient, after 2Y of survival, had the same probability of relapse and survival as a favourable/intermediate risk patient.

Serum Lactate Dehydrogenase Isoenzyme 1 and Relapse in Patients with Nonseminomatous Testicular Germ Cell Tumors Clinical Stage I

2001 ◽  
Vol 40 (4) ◽  
pp. 536-540 ◽  
Author(s):  
Finn Edler von Eyben ◽  
Ebbe Lindegaard Madsen ◽  
Ole Blaabjerg ◽  
Per Hyltoft Petersen ◽  
Hans von der Maase ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Germ Cell ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Serum Lactate ◽  
Stage I ◽  
Serum Lactate Dehydrogenase ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
Dehydrogenase Isoenzyme

Molecular Mechanisms of Resistance in Testicular Germ Cell Tumors - clinical Implications

2018 ◽  
Vol 18 (10) ◽  
pp. 967-978 ◽  
Author(s):  
Katarina Kalavska ◽  
Vincenza Conteduca ◽  
Ugo De Giorgi ◽  
Michal Mego
Keyword(s):  
Germ Cell ◽  
Molecular Mechanisms ◽  
Cisplatin Resistance ◽  
Apoptotic Cell ◽  
Germ Cell Tumors ◽  
Treatment Resistance ◽  
Experimental Models ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
Repair Capacity

Testicular germ cell tumors (TGCTs) represent the most common malignancy in men aged 15-35. Due to these tumors’ biological and clinical characteristics, they can serve as an appropriate system for studying molecular mechanisms associated with cisplatin-based treatment resistance. This review describes treatment resistance from clinical and molecular viewpoints. Cisplatin resistance is determined by various biological mechanisms, including the modulation of the DNA repair capacity of cancer cells, alterations to apoptotic cell death pathways, deregulation of gene expression pathways, epigenetic alterations and insufficient DNA binding. Moreover, this review describes TGCTs as a model system that enables the study of the cellular features of cancer stem cells in metastatic process and describes experimental models that can be used to study treatment resistance in TGCTs. All of the abovementioned aspects may help to elucidate the molecular mechanisms underlying cisplatin resistance and may help to identify promising new therapeutic targets.

Sign in / Sign up

Export Citation Format

Share Document