EP838 Current status of oncofertility care for the AYA cancer patients with ovarian germ cell tumors in japan – a fact-finding survey by japan agency for medical research and development (AMED)

2019 ◽  
Author(s):  
H Endo ◽  
N Yoshioka ◽  
H Yamanaka ◽  
S Kuji ◽  
I Deura ◽  
...  
Keyword(s):  
Research And Development ◽  
Germ Cell ◽  
Medical Research ◽  
Cancer Patients ◽  
Germ Cell Tumors ◽  
Current Status ◽  
Fact Finding

The Second Medical Research Council Study of Prognostic Factors in Nonseminomatous Germ Cell Tumors

1992 ◽  
Vol 10 (5) ◽  
pp. 867-867 ◽  
Author(s):  
G.M. Mead ◽  
S.P. Stenning ◽  
M.C. Parkinson ◽  
A. Horwich ◽  
S.D. Fossa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Germ Cell ◽  
Medical Research ◽  
Research Council ◽  
Embryonal Carcinoma ◽  
Medical Research Council ◽  
Lung Metastases ◽  
Fibrous Tissue ◽  
Germ Cell Tumors ◽  
Nonseminomatous Germ Cell Tumors

In the report entitled, "The Second Medical Research Council Study of Prognostic Factors in Nonseminomatous Germ Cell Tumors" by Mead et al (J Clin Oncol 10:85–94, 1992), the second sentence in the Results section of the abstract should have read: "The independently adverse features proved to be (1) the presence of liver, bone, or brain metastases; (2) raised marker levels (alpha-fetoprotein [AFP] level > 1,000 kU/L or beta subunit of human chorionic gonadotropin [HCG] > 10,000 IU/L); (3) the presence of a mediastinal mass greater than 5 cm in diameter; (4) the presence of 20 or more lung metastases; (5) increasing age; and (6) absence of undifferentiated teratoma (embryonal carcinoma) or fibrous tissue from the primary tumor."

Short-course adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumors of the testis: a Medical Research Council report.

1996 ◽  
Vol 14 (4) ◽  
pp. 1106-1113 ◽  
Author(s):  
M H Cullen ◽  
S P Stenning ◽  
M C Parkinson ◽  
S D Fossa ◽  
S B Kaye ◽  
...  
Keyword(s):  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Germ Cell ◽  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Nonseminomatous Germ Cell Tumors

PURPOSE This United Kingdom Medical Research Council (UK-MRC) study prospectively evaluated efficacy and long-term toxicity of adjuvant chemotherapy in high-risk stage I nonseminomatous germ cell tumors of the testis (NSGCTT). PATIENTS AND METHODS Eligible patients were those identified by the local histopathologist as having features confirmed in MRC surveillance studies to indicate an approximate 50% risk of relapse. Central histopathology review was undertaken. Chemotherapy consisted of two courses of cisplatin 100 mg/m2, bleomycin 30 mg weekly x 3, and etoposide 120 mg/m2 x 3, every 21 days (BEP). RESULTS One hundred fourteen eligible cases were enrolled. Median time of follow-up was 4 years, with 93 patients followed-up for at least 2 years. There have been two relapses, including one patient who did not have a germ cell tumor (GCT), according to the reference histopathologist. This patient is alive with active disease, the other has died. There was one death after a cerebrovascular accident during treatment. Assessment of fertility, lung function, and audiometry pretreatment and more than 9 months posttreatment indicated no clinically significant changes. A mean decrease in transfer factor coefficient (KCO) of 15% of the predicted value was noted, but no patient had symptomatic respiratory dysfunction. CONCLUSION There have been only two relapses among 114 cases of high-risk stage I NSGCTT treated with two courses of adjuvant BEP chemotherapy. The 95% confidence interval (CI) excludes a true relapse rate of more than 5%. Of 104 patients confirmed on histopathology review to have GCT, there has been only one relapse. Adjuvant chemotherapy is free from significant long-term toxicity, offering an effective alternative to surveillance or retroperitoneal lymph node dissection (RPLND) followed by surveillance, and may be preferred by some patients.

scholarly journals Sperm cryopreservation of male cancer patients for  fertility preservation : 10-year monocentric experience

2021 ◽  
Author(s):  
Xiao Liu ◽  
Bo Liu ◽  
shasha liu ◽  
yang xian ◽  
wenrui zhao ◽  
...  
Keyword(s):  
Germ Cell ◽  
Cancer Patients ◽  
Fertility Preservation ◽  
Sperm Quality ◽  
Germ Cell Tumors ◽  
Semen Parameters ◽  
Sperm Cryopreservation ◽  
Sperm Banking ◽  
Hematological Neoplasms ◽  
Body Regions

Abstract Background: Semen cryopreservation is an effective method to preserve fertility, which is very important for male cancer patients. Unfortunately, due to unaware of the opportunities for sperm cryopreservation for both physicians and cancer patients, not a lot of data on evaluating the semen parameters and dispositions of the cryopreserved samples of Chinese cancer population are available in the literature. Methods: We retrospectively reviewed semen parameters as well as the clinical outcomes of assisted reproductive treatments (ART) of 339 male cancer patients of Chinese population who were referred to our center from 2010 to 2019 for fertility preservation. Results: We first classify the male tumors into six major types according to body regions. The most prevalent cancer patients who came from our cohort for sperm banking were hematological neoplasms patients, and the second cancers were germ cell tumors. Patients with germ cell tumors had the lowest pre- thaw and post-thaw concentration among the six major cancer types. However, we separately compared among testicular tumors, lymphoma and leukemia, it turned out that leukemia had the lowest pre-thaw concentration. Most cancer patients (58%) chose to go on keeping their specimens in storage. The second proportion selected to discard their specimens electively (31%). Over the years, there were only 13 patients (4%) returned to use their sperm by ART. In the storage samples, germ cell tumors were the most proportion ones (29.3%). Moreover, in the unfrozen samples, the percentage of hematological neoplasms were the most (45.5%).Conclusions: To our knowledge, we had owned the most numbers of male cancers who came to sperm bank for fertility conservation in the southwest of China. In our study we suggested that sperm quality could decrease even before antineoplastic treatment and sperm banking prior to treatment should be strongly recommended for male cancer patients. 

The Second Medical Research Council study of prognostic factors in nonseminomatous germ cell tumors. Medical Research Council Testicular Tumour Working Party.

1992 ◽  
Vol 10 (1) ◽  
pp. 85-94 ◽  
Author(s):  
G M Mead ◽  
S P Stenning ◽  
M C Parkinson ◽  
A Horwich ◽  
S D Fossa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Germ Cell ◽  
Medical Research ◽  
Research Council ◽  
Medical Research Council ◽  
Lung Metastases ◽  
Large Population ◽  
Germ Cell Tumors ◽  
Cox Regression Analysis ◽  
Nonseminomatous Germ Cell Tumors

PURPOSE To assess prognostic factors in a large population of patients with metastatic nonseminomatous germ cell tumors (NSGCT) arising in gonadal or extragonadal sites. PATIENTS AND METHODS Data from 795 patients treated with chemotherapy between 1982 and 1986 in 13 centers were analyzed. Particular emphasis was placed on exact tumor measurements (eg, size of nodal masses, number of lung metastases), and the diagnostic pathology was also reviewed. Cox regression analysis was performed on these data. The patients were treated with a variety of cisplatin-containing chemotherapy regimens, 86% of which included etoposide. RESULTS With median follow-up of 45 months, overall 3-year survival is 85%. The independently adverse features proved to be (1) the presence of liver, bone, or brain metastases; (2) raised marker levels (alpha-fetoprotein [AFP] level greater than 1,000 kU/L or beta subunit of human chorionic gonadotropin [HCG] greater than 10,000 IU/L [corrected]); (3) the presence of a mediastinal mass greater than 5 cm in diameter; (4) the presence of 20 or more lung metastases; (5) increasing age; and (6) absence of undifferentiated teratoma (embryonal carcinoma) or fibrous tissue from the primary tumor. CONCLUSIONS The first four factors were used to define a simple prognostic classification. A good-prognosis group having none of these features comprised 67% of our patient population and had a 3-year survival of 93%. The remaining 33% of patients having at least one of these features had a 3-year survival rate of 68%. These patient groups are currently the subjects of international randomized clinical trials.

Increase in lactate dehydrogenase isoenzyme-1 in plasma in pediatric malignancy

1990 ◽  
Vol 36 (9) ◽  
pp. 1683-1685 ◽  
Author(s):  
S S Sacks ◽  
G Mulligan
Keyword(s):  
Lactate Dehydrogenase ◽  
Germ Cell ◽  
Cancer Patients ◽  
Acute Lymphocytic Leukemia ◽  
Wilms Tumor ◽  
Germ Cell Tumors ◽  
Lymphocytic Leukemia ◽  
Pediatric Malignancy ◽  
Dehydrogenase Isoenzyme

Abstract We investigated 28 cases of pediatric malignancy in which total lactate dehydrogenase (LD, EC 1.1.1.27) activities were increased and isoenzyme LD-1 exceeded LD-2 (flipped pattern). Of these, 11 had a flipped pattern at presentation and 17 showed a flipped pattern during chemotherapy. Those with flipped patterns at presentation were four with germ-cell tumors, one with acute lymphocytic leukemia, and six with nephroblastomas (Wilms tumor). Four of five nephroblastoma homogenates contained predominantly LD-1; one revealed a structurally normal LD-1 with normal kinetics. We conclude that an increase in LD with a flipped pattern is common in nephroblastoma and, in addition, may develop in cancer patients treated with chemotherapy.

scholarly journals Between a Rock and a Hard Place: An Epigenetic-Centric View of Testicular Germ Cell Tumors

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1506
Author(s):  
Ratnakar Singh ◽  
Zeeshan Fazal ◽  
Sarah J. Freemantle ◽  
Michael J. Spinella
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Current Status ◽  
Testicular Germ Cell Tumors ◽  
Driver Genes ◽  
Testicular Germ Cell ◽  
Response To Chemotherapy ◽  
Chromosome 12P ◽  
Epigenetic Biomarker ◽  
Hard Place

Compared to many common solid tumors, the main genetic drivers of most testicular germ cell tumors (TGCTs) are unknown. Decades of focus on genomic alterations in TGCTs including awareness of a near universal increase in copies of chromosome 12p have failed to uncover exceptional driver genes, especially in genes that can be targeted therapeutically. Thus far, TGCT patients have missed out on the benefits of targeted therapies available to treat most other malignancies. In the past decade there has been a greater appreciation that epigenetics may play an especially prominent role in TGCT etiology, progression, and hypersensitivity to conventional chemotherapy. While genetics undoubtedly plays a role in TGCT biology, this mini-review will focus on the epigenetic “states” or features of testicular cancer, with an emphasis on DNA methylation, histone modifications, and miRNAs associated with TGCT susceptibility, initiation, progression, and response to chemotherapy. In addition, we comment on the current status of epigenetic-based therapy and epigenetic biomarker development for TGCTs. Finally, we suggest a unifying “rock and a hard place” or “differentiate or die” model where the tumorigenicity and curability of TGCTs are both dependent on common but still ill-defined epigenetic states.

Risk factors for thromboembolic events in testicular cancer patients receiving chemotherapy

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16109-e16109
Author(s):  
K. Shim ◽  
K. R. Potvin ◽  
K. Mills ◽  
F. Whiston ◽  
L. Stitt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Germ Cell ◽  
Cancer Patients ◽  
Cell Cancer ◽  
Germ Cell Tumors ◽  
Retrospective Chart Review ◽  
Germ Cell Cancer ◽  
Thromboembolic Events ◽  
Increased Risk ◽  
Risk Of Hemorrhage

e16109 Background: Cancer patients are at increased risk for thromboembolic events (TTEs), and those receiving chemotherapy are at even greater risk. Clinical experience and the literature have suggested that men receiving cisplatin-based chemotherapy for metastatic germ cell tumors are at particularly high risk. As TTEs can be fatal and treatment is curative, the stakes are high. Despite this, prophylactic anticoagulation (PA) is not routinely used. Methods: All men treated with cisplatin-based chemotherapy for metastatic germ cell cancer at the London Regional Cancer Program from January 1978 to December 2007 were identified from electronic databases. Data including type and timing of TTEs were extracted by retrospective chart review. Multivariable analyses were used to identify predictors of TTEs. Results: 196 eligible patients were identified with median age 31 years (range, 15–75). No patients received PA. Thirty-two TTEs were identified in 29 patients for an overall incidence of 14.8% (95% CI, 9.8–19.8%). The majority of events were deep venous thromboses, and five patients died due to TTE or its complications. Sixteen of the patients with TTE (55.2%) were diagnosed while on treatment (defined as TTE within 6 months of chemotherapy initiation); 8 (27.6%) had their TTE prior to, and 5 (17.2%) after this time period. Age greater than 30 years (OR = 3.02; 95% CI, 1.10–8.33; p = 0.033) and elevated LDH (OR = 1.93; 95% CI, 1.07–3.48; p = 0.029) were independently associated with an increased risk of TTE. If both adverse risk factors were present, the risk of TTE on treatment was 21.7% (95% CI, 9.8–33.7%). If neither were present, the negative predictive value was 97% (95% CI, 92–100%). Conclusions: The overall TTE incidence rate of 14.8% is consistent with prior reports (8.4–19%). The risk of TTE appears greatest during chemotherapy and shortly thereafter, and nearly one in 10 patients in this group had a TTE. These data support the concept of PA for selected patients starting chemotherapy for metastatic germ cell cancer. However, the efficacy of PA and risk of hemorrhage in this group is unknown. In this cohort, patients under 30 with normal LDH were at very low risk for TTE. Confirmation of these findings to help guide the study and optimal use of PA should be pursued. No significant financial relationships to disclose.

Intensive induction-sequential chemotherapy with BOP/VIP-B compared with treatment with BEP/EP for poor-prognosis metastatic nonseminomatous germ cell tumor: a Randomized Medical Research Council/European Organization for Research and Treatment of Cancer study.

1998 ◽  
Vol 16 (2) ◽  
pp. 692-701 ◽  
Author(s):  
S B Kaye ◽  
G M Mead ◽  
S Fossa ◽  
M Cullen ◽  
R deWit ◽  
...  
Keyword(s):  
Germ Cell ◽  
Medical Research ◽  
Poor Prognosis ◽  
Research Council ◽  
Medical Research Council ◽  
Lung Metastases ◽  
Germ Cell Tumors ◽  
Sequential Chemotherapy ◽  
European Organization ◽  
Significant Difference

PURPOSE The aim of this randomized trial was to assess the potential therapeutic advantage of an intensive induction-sequential chemotherapy schedule (bleomycin, vincristine, cisplatin [BOP])/etoposide, ifosfamide, cisplatin, and bleomycin [VIP-B]), compared with a regimen based on bleomycin, etoposide, and cisplatin (BEP) (BEP/etoposide and cisplatin [EP]) for the treatment of patients with poor-prognosis metastatic nonseminomatous germ cell tumors (NSGCTs). PATIENTS AND METHODS Patients had one or more of the following: a retroperitoneal mass > or = 10 cm in diameter; mediastinal or supraclavicular mass > or = 5 cm in diameter; at least 20 lung metastases (any size); liver, bone, or brain metastases; and serum beta human chorionic gonadotropin (betaHCG) > or = 10,000 IU/L or alfa fetoprotein (AFP) > or = 1,000 IU/L. A total of 380 patients were accrued between May 1990 and June 1994 into this joint Medical Research Council (MRC)/European Organization for Research and Treatment of Cancer (EORTC) trial; of these, nine patients were deemed ineligible. RESULTS There was no significant difference between the two arms in the proportion of patients who achieved a complete response (CR) with chemotherapy alone, ie, 79 of 185 assessable patients (57%) with BEP/EP and 72 of 186 (54%) with BOP/VIP-B (P = 0.687). With a median follow-up of 3.1 years (maximum, 5.8), a total of 107 patients (28%) had progressive disease. There was no significant difference in time to first disease progression, or failure-free or overall survival between the two arms (P = 0.21, 0.101, and 0.190, respectively). The 1-year failure-free survival rates for BEP/EP and BOP/VIP-B were 60% (95% confidence interval [CI], 53% to 67%) and 53% (95% CI, 47% to 61%). Grade 3 or 4 myelosuppression, febrile neutropenia, and weight loss were more pronounced with BOP/VIP-B than with BEP/EP, and there were more toxic deaths with BOP/VIP-B than BEP/EP (18 [9%] v nine [5%]). CONCLUSION The intensive BOP/VIP-B therapy was associated with more toxicity, but there was no evidence of an improvement in response rate or survival compared with treatment with BEP/EP.

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