Clinicopathologic predictors of outcomes in children with stage I testicular germ cell tumors: A pooled post hoc analysis of trials from the Children's Oncology Group

Singla, Nirmish; Wong, Joshua; Singla, Shyamli; Krailo, Mark; Huang, Li; Shaikh, Furqan; Billmire, Deborah F.; Rescorla, Frederick J.; Ross, Jonathon; Dicken, Bryan; Amatruda, James F.; Frazier, Lindsay; Bagrodia, Aditya

doi:10.1016/j.jpurol.2022.04.022

Cited by 2 publications

(4 citation statements)

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“…Singla et al. confirmed outstanding OS of 100% in males with clinical stage I testicular GCT despite increased rates of relapse with older age and pT AJCC staging 33 . These findings support surveillance in prepubertal patients with low‐risk (LR) testicular tumors.…”

Section: Major Findingsmentioning

confidence: 81%

“…AYA, adolescent and young adult; LR, low risk; SR, standard risk; PEb, cisplatin, etoposide, bleomycin once per cycle; HD-PEb, high-dose PEb; C-PEb, cyclophosphamide-PEb; TIC, paclitaxel, ifosfamide, carboplatin; BEP, bleomycin weekly, etoposide, cisplatin; BEC, bleomycin weekly, etoposide, carboplatin; CEb, carboplatin, etoposide, bleomycin once per cycle; TIP, paclitaxel, ifosfamide, cisplatin; TI-CE, paclitaxel, ifosfamide, carboplatin, etoposide. observation alone 32,33. AGCT0132 followed patients with stage I gonadal tumors with surveillance alone; 4-year event-free survival33 These findings support surveillance in prepubertal patients with low-risk (LR) testicular tumors.…”

mentioning

confidence: 73%

“…observation alone 32,33. AGCT0132 followed patients with stage I gonadal tumors with surveillance alone; 4-year event-free survival33 These findings support surveillance in prepubertal patients with low-risk (LR) testicular tumors. Management in AYA men with testicular GCTs is more controversial, because several treatment options including surveillance, one cycle of BEP (bleomycin weekly, etoposide, cisplatin), or retroperitoneal lymph node dissection (RPLND) deliver similar outcomes.Stage I malignant ovarian GCTs can also be treated with surveillance alone.…”

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confidence: 73%

“…Intergroup studies and AGCT0132 successfully demonstrated that stage I gonadal GCTs can be treated with surgical resection and observation alone 32,33 . AGCT0132 followed patients with stage I gonadal tumors with surveillance alone; 4‐year event‐free survival (EFS) and OS in males was 74% and 100%, respectively.…”

Section: Major Findingsmentioning

confidence: 99%

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Children's Oncology Group's 2023 blueprint for research: Germ cell tumors

Bhuta

Shah

Gell

et al. 2023

Pediatric Blood & Cancer

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Extracranial germ cell tumors (GCT) are a biologically diverse group of tumors occurring in children, adolescents, and young adults. The majority of patients have excellent outcomes, but treatment‐related toxicities impact their quality of survivorship. A subset of patients succumbs to the disease. Current unmet needs include clarifying which patients can be safely observed after initial surgical resection, refinement of risk stratification to reduce chemotherapy burden in patients with standard‐risk disease, and intensify therapy for patients with poor‐risk disease. Furthermore, enhancing strategies for detection of minimal residual disease and early detection of relapse, particularly in serum tumor marker‐negative histologies, is critical. Improving the understanding of the developmental and molecular origins of GCTs may facilitate discovery of novel targets. Future efforts should be directed toward assessing novel therapies in a biology‐driven, biomarker‐defined, histology‐specific, risk‐stratified patient population. Fragmentation of care between subspecialists restricts the unified study of these rare tumors. It is imperative that trials be conducted in collaboration with national and international cooperative groups, with harmonized data and biospecimen collection. Key priorities for the Children's Oncology Group (COG) GCT Committee include (a) better understanding the biology of GCTs, with a focus on molecular targets and mechanisms of treatment resistance; (b) strategic development of pediatric and young adult clinical trials; (c) understanding late effects of therapy and identifying individuals most at risk; and (d) prioritizing diversity, equity, and inclusion to reduce cancer health disparities and studying the impacts of social determinants of health on outcomes.

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Section: Major Findingsmentioning

confidence: 81%

mentioning

confidence: 73%

mentioning

confidence: 73%

Section: Major Findingsmentioning

confidence: 99%

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