Oncotarget

Research Papers:

Survival outcomes of patients with germ cell tumors treated with high-dose chemotherapy for refractory or relapsing disease

Stefanie Zschäbitz _, Florian A. Distler, Benjamin Krieger, Patrick Wuchter, Kerstin Schäfer-Eckart, Maximilian Jenzer, Markus Hohenfellner, Peter Dreger, Georg Martin Haag, Dirk Jäger, Sascha Pahernik and Carsten Grüllich

PDF  |  HTML  |  Supplementary Files  |  How to cite  |  Order a Reprint

Oncotarget. 2018; 9:22537-22545. https://doi.org/10.18632/oncotarget.25162

Metrics: PDF 785 views  |   HTML 1284 views  |   ?  


Abstract

Stefanie Zschäbitz1, Florian A Distler2, Benjamin Krieger3, Patrick Wuchter4,6, Kerstin Schäfer-Eckart3, Maximilian Jenzer1, Markus Hohenfellner5, Peter Dreger4, Georg Martin Haag1, Dirk Jäger1, Sascha Pahernik2 and Carsten Grüllich1

1Department of Medical Oncology, National Center for Tumor Diseases, University Hospital Heidelberg, 69120 Heidelberg, Germany

2Department of Urology, Paracelsus Medical University, 90419 Nuremberg, Germany

3Department of Oncology and Hematology, Paracelsus Medical University, 90419 Nuremberg, Germany

4Department of Hematology, Oncology, and Rheumatology, University Hospital Heidelberg, 69120 Heidelberg, Germany

5Department of Urology, University Hospital Heidelberg, 69120 Heidelberg, Germany

6Present address: Institute for Transfusion Medicine and Immunology Mannheim, Medical Faculty Mannheim, University of Heidelberg, DRK-Blutspendedienst Baden-Württemberg–Hessen gGmbH, 68167 Mannheim, Germany

Correspondence to:

Carsten Grüllich, email: carsten.gruellich@med.uni-heidelberg.de

Keywords: autologous stem cell transplantation; high-dose chemotherapy; germ cell tumor; relapse; testicular cancer

Received: January 16, 2018     Accepted: April 04, 2018     Published: April 27, 2018

ABSTRACT

Introduction: Male patients with metastatic germ cell tumors can be cured in up to 96% of cases depending on stage and IGCCCG prognosis group. Treatment in relapse consists of conventional or high-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) combined with local treatment modalities.

Results: Most patients were classified as poor risk according to IGCCCG (n = 24; 52%) and as intermediate (n = 12), high (n = 16), or very high risk (n = 9) at time of first relapse according to IPFSG criteria. In 67% of patients (n = 31) HDCT/ASCT was performed as first salvage treatment in relapse or for primary refractory disease following first line chemotherapy. In 46% of patients (n = 21) progressive disease was documented after mobilization and prior to HDCT/ASCT. Median progression free survival (mPFS) was 7.4 months (95% confidence interval (CI): 1.3–13.6) while median overall survival (mOS) was 22.2 months (95% CI: 8.9–35.5). When stratified for IPFSG risk group, mPFS (p < 0.001) and mOS (p = 0.009) differed significantly between risk groups (very low vs. low vs. intermediate vs. high vs. very high). Metastases to liver/bone/brain and platinum refractory disease were independent risk factors for inferior PFS (p = 0.024; p = 0.008) but not OS.

Materials and Methods: Forty-six patients treated with HDCT/ASCT at the university clinics in Heidelberg and Nuremberg between 2000–2016 were identified and analyzed. Data was collected retrospectively.

Conclusions: HDCT/ASCT offers a potential curative strategy for patients with relapsed GCT. Improvement is still needed in patients with intermediate, high, and very high IPFSG risk group.


Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 3.0 License.
PII: 25162