scholarly journals Is high-dose chemotherapy based on carboplatin, a late dose-intensification of a cisplatin-based salvage chemotherapy in germ cell tumour patients?

2006 ◽  
Vol 17 (3) ◽  
pp. 530-531
Author(s):  
U. De Giorgi
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumour ◽  
High Dose Chemotherapy ◽  
Salvage Chemotherapy ◽  
Cell Tumour ◽  
High Dose ◽  
Dose Intensification

Cerebral metastases in non-seminomatous germ cell tumour patients undergoing primary high-dose chemotherapy

2008 ◽  
Vol 44 (12) ◽  
pp. 1663-1669 ◽  
Author(s):  
K. Oechsle ◽  
C. Kollmannsberger ◽  
F. Honecker ◽  
I. Boehlke ◽  
C. Bokemeyer
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumour ◽  
High Dose Chemotherapy ◽  
Cerebral Metastases ◽  
Cell Tumour ◽  
High Dose

Long-Term Survival After High-Dose Salvage Chemotherapy for Germ Cell Malignancies With Adverse Prognostic Variables

2003 ◽  
Vol 21 (22) ◽  
pp. 4100-4104 ◽  
Author(s):  
Daniel A. Vaena ◽  
Rafat Abonour ◽  
Lawrence H. Einhorn
Keyword(s):  
Germ Cell ◽  
Poor Prognosis ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Prognostic Variables ◽  
Term Survival ◽  
Risk Patients ◽  
Platinum Refractory

Purpose: Independent prognostic variables for patients undergoing high-dose chemotherapy (HDCT) as salvage modality for germ cell tumors (GCT) were previously described, and a score was created. Patients with more than 2 points had a poor prognosis. However, these data were from patients treated from 1984 to 1993, and most received a single HDCT course. In this study, we evaluated outcomes at Indiana University and determined the applicability of the Beyer score to contemporary poor-risk patients. Patients and Methods: We performed a retrospective analysis of patients who received salvage HDCT between 1988 and 2001 and had at least one of the following characteristics: platinum-refractory or absolutely platinum-refractory GCT, primary mediastinal nonseminomatous GCT (PMNSGCT), human chorionic gonadotropin (HCG) ≥ 1,000 mU/mL or alpha-fetoprotein (AFP) ≥ 1,000 ng/mL before HDCT. Primary end points were overall and 2-year failure-free survival (FFS). Results: Eighty patients were identified. Fifty-six were platinum refractory, 23 had a Beyer score greater than 2, and 13 had PMNSGCT. Fifty-six patients received two HDCT courses. HDCT included carboplatin and etoposide. Forty-three patients received HDCT as first salvage modality. Median overall survival was 14.7 months. The 2-year FFS was 32%. No relapses have occurred after 2 years from HDCT. Patients with greater than 2 points in the Beyer score, platinum-refractory patients, and patients with HCG ≥ 1,000 mU/mL, AFP ≥ 1,000 ng/mL, and PMNSGCT had 2-year FFS of 30%, 37%, 26%, 18%, and 0%, respectively. Conclusion: Results with PMNSGCT remained poor. However, other patients with poor prognosis should not be denied an attempt at curative salvage HDCT.

Visible haematuria—an unusual presentation of metastatic testicular mixed germ cell tumour

2021 ◽  
Vol 14 (3) ◽  
pp. e241056
Author(s):  
Diarmuid Declan Sugrue ◽  
James Ryan ◽  
Johnathon Harris ◽  
Ijaz Cheema
Keyword(s):  
Germ Cell ◽  
Bladder Wall ◽  
Short Interval ◽  
Germ Cell Tumour ◽  
Final Diagnosis ◽  
Salvage Chemotherapy ◽  
Cell Tumour ◽  
Assess Treatment Response ◽  
Yolk Sac Tumour ◽  
Wall Mass

A 29-year-old male patient presented to the emergency department with haematuria and flank pain. Ten months agopreviously, he had undergone orchidectomy and adjuvant chemotherapy for a testicular mixed germ cell tumour. Cystoscopy revealed a large bladder wall mass. The final diagnosis of yolk sac tumour was established after transurethral resection of the lesion. The patient was treated with salvage chemotherapy and placed on short-interval biochemical and radiological surveillance to assess treatment response.

High-dose chemotherapy (HDCT) as second salvage treatment in patients with multiple relapsed or refractory germ cell tumors

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5082-5082
Author(s):  
J. Beyer ◽  
M. Hackenthal ◽  
A. Lorch ◽  
A. Neubauer ◽  
A. Dieing ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Median Number ◽  
High Dose Chemotherapy ◽  
Salvage Chemotherapy ◽  
Salvage Treatment ◽  
Additional Patient ◽  
High Dose ◽  
First Line ◽  
Conventional Dose

5082 Background: To determine the activity of high-dose chemotherapy (HDCT) as intensification of second salvage treatment (SST) in patients with multiple relapsed germ-cell tumors (GCT). Methods: Databases in Berlin and Marburg (Germany) on patients treated with HDCT between 1989 and 2008 for germ-cell tumors were screened. Among 534 patients overall, 71/534 (13%) patients were identified as scheduled for HDCT having failed at least one previous conventional-dose first-line and first-salvage chemotherapy regimen. Forty-nine patients who had received at least cisplatin- and etoposide as first-line as well as conventional-dose cisplatin as first-salvage treatment and were diagnosed after January 1, 1990, were further analyzed. Results: Median age at SST was 32 years (range 19 to 52 years). Median follow-up for surviving patients was 4 years (range 1,7 to 8,5 years). Histology was pure seminoma in 5/49 (10%) patients and non-seminoma or mixed histologies in 44/49 (90%). The median number of cisplatin-based treatment cycles prior to SST was 7 (range 5 to 11 cycles). Three of forty-nine (6%) patients either progressed or died prior to scheduled HDCT, the remaining 46/49 (94%) received either single or sequential HDCT. The rate of favorable responses to HDCT as intensification of SST was 27/49 (55%). Ten patients are alive without progression. One additional patient is lost-to-follow at four years without progression. The projected overall survival rate at five years after initiation of SST was 17%. Conclusions: HDCT can induce long term remissions even in patients with multiple relapsed GCT. No significant financial relationships to disclose.

Liver metastases in germ cell tumors.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 403-403
Author(s):  
Suliman Boulos ◽  
Jonathan Shamash ◽  
Han Hsi Wong ◽  
Sarah Maria Rudman ◽  
Gary Doherty ◽  
...  
Keyword(s):  
Liver Resection ◽  
Germ Cell ◽  
Mature Teratoma ◽  
Germ Cell Tumour ◽  
Germ Cell Tumors ◽  
Adverse Outcomes ◽  
Cell Tumour ◽  
Retroperitoneal Lymph Node Dissection ◽  
High Dose ◽  
Response To Chemotherapy

403 Background: Metastatic germ cell tumour (GCT) to the liver is considered rare and usually caries adverse outcomes. We aimed to determine the outcome of patients with metastatic GCT to the liver. Methods: We identified retrospectively 36 patients with metastatic germ cell tumour to the liver between the years 2001 and 2015, from which 34 were non-seminomatous germ cell tumours (NSGCT) and two seminomas. 35 patients had other sites of metastases including lungs, bones and brain. Elevated tumour markers were seen in the vast majority of patients (97.2%). 15 patients received treatment with dose intense regime including actinomycin-D, high-dose methotrexate, etoposide and cisplatin (GAMEC) every 14 days, 20 patients received the standard protocol of bleomycin, etoposide and cisplatin (BEP) every 21 days and one patient received POMB/ACE chemotherapy. 20 patients had an induction cycle of cisplatin, vincristine and bleomycin (Baby-BOP) prior to initial treatment. Results: 12 patients had radiological complete response (CR) and 19 patients had radiological partial response (PR) in the liver, with five patients having a CR in all sites with negative markers. Five patients underwent liver resection with no viable tumour seen. Three patients that underwent liver resection also had retroperitoneal lymph node dissection (RPLND) the histology from which was viable seminoma in one case, mature teratoma in one case and necrosis in the final patient.16 patients had marker negative PR, 10 patients had marker positive PR and 5 patients had a marker negative CR. 15 patients eventually relapsed and 10 died with only one liver relapse. Median Overall survival for patients that received BEP was 35.38 months (not reached for GAMEC) (p = 0.0147). The median progression free survival (PFS) for the BEP group was 24.45 months (not reached for GAMEC) (p = 0.22) and the 2-years PFS for the GAMEC and BEP groups were 73% and 55% respectively. Conclusions: Within this cohort, liver metastasis from germ-cell tumour had a good response to chemotherapy, with progression occurring mainly in extra-hepatic sites. There was also a suggestion that dose dense GAMEC regime may offer superior efficacy compared with BEP.These results also question the role of liver metastectomy after initial response to chemotherapy.

Can patients (pts.) with refractory germ cell tumors (GCT) be cured after progression following high dose chemotherapy (HDCT) with tandem transplant? Results with paclitaxel + gemcitabine

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4588-4588
Author(s):  
D. A. Lewis ◽  
M. J. Brames ◽  
L. H. Einhorn
Keyword(s):  
Germ Cell ◽  
Objective Response ◽  
Germ Cell Tumors ◽  
Disease Free Survival ◽  
High Dose Chemotherapy ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
Indiana University

4588 Background: A previously published ECOG study of paclitaxel (P) plus gemcitabine (G) in refractory germ cell tumors achieved a 21% response rate (6 of 28 pts.) (JCO 20:1859, 2002). Two patients are continuously NED for 4+ years. Neither had prior HDCT. High dose salvage chemotherapy with carboplatin + etoposide and peripheral blood stem cell transplant has curative potential. Subsequent chemotherapy after progression following HDCT has only rarely achieved durable remission. We have retrospectively reviewed pts. treated at Indiana University with P + G after failure to cure with initial cisplatin combination chemotherapy and salvage HDCT (± other salvage regimens). Methods: 184 patients received salvage HDCT from February 1996 to December 2004. After further progression, 33 pts. were treated with P 100 mg/M2 over 1 hour and G 1000 mg/M2 over 30 minutes days 1, 8, and 15 every 4 weeks for a maximum of 6 courses. Pts. were ineligible if they received prior P or G. 26 pts. received P + G as 3rd line, 6 as 4th line and 1 as 5th line chemotherapy. Results: Toxicity was primarily myelosuppression and neuropathy, as previously described with P + G (JCO 20:1859, 2002). There was no treatment related mortality. 10 of 33 pts. achieved objective response including 4 partial (2 to 6 months duration) and 6 complete responses (C.R.). 4 of the 6 C.R.s are continuously NED with P + G alone at 14+, 34+, 44+, and 45+ months from start of P + G. One additional C.R. is currently NED 54+ months after P + G, with 2 subsequent resections of carcinoma. Conclusions: Long-term disease free survival and potential cure is possible with P + G in this patient population after progression following HDCT. [Table: see text]

scholarly journals Salvage Therapy for Patients With Germ Cell Tumor

2016 ◽  
Vol 12 (5) ◽  
pp. 437-443 ◽  
Author(s):  
Sawsan Rashdan ◽  
Lawrence H. Einhorn
Keyword(s):  
Survival Rate ◽  
Germ Cell ◽  
Combination Chemotherapy ◽  
Standard Dose ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
Salvage Chemotherapy ◽  
High Dose ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell

The introduction of cisplatin combination chemotherapy, 40 years ago, transformed metastatic testicular germ cell tumors from an almost uniformly fatal disease into a model for a curable neoplasm. Before the era of platinum combination chemotherapy, the 5-year survival rate among men with metastatic testicular germ cell tumors was 5% to 10%. Currently, the 5-year survival rate is 80% for patients with metastatic disease and 95% overall. Despite the substantial advances in the treatment of germ cell tumors, 20% to 30% of patients will relapse after first-line chemotherapy and will require additional salvage therapies. Standard-dose or high-dose chemotherapy can cure ≤ 50% of these patients. Relapses after high-dose chemotherapy generally carry a poor prognosis; however, cure is still possible in a small percentage of patients by using further salvage chemotherapy or salvage surgery.

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