First-line high-dose chemotherapy for patients with poor prognosis extragonadal germ cell tumors: the experience of the European Bone Marrow Transplantation (EBMT) Solid Tumors Working Party

Rosti, Gianantonio; Giorgi, Ugo De; Wandt, Hannes; Lioure, Bruno; Leyvraz, Serge; Kolbe, Karin; Papiani, Giorgio; Ballardini, Michela; Kulekci, A; Demirer, Taner

doi:10.1038/sj.bmt.1704704

Cited by 25 publications

(16 citation statements)

References 20 publications

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“…More investigations need to be done to determine whether race is one of the contributors to the poor prognosis of EGCT. Several reports showed that EGCT in mediastina has a worse outcome than EGCT in other sites [15-17]. To our knowledge, there is no report about YST primarily arising in the seminal vesicle.…”

Section: Discussionmentioning

confidence: 91%

Primary yolk sac tumor of seminal vesicle: a case report and literature review

Yao

Hong

et al. 2012

World J Surg Onc

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BackgroundYolk sac tumor (endodermal sinus tumor) is a rare malignant germ cell tumor arising in the testis or ovary. Extragonadal yolk sac tumor is even rarer and has only been described in case reports. Due to the rarity of the tumors, the appropriately optimal treatment remains unclear. We report a case of yolk sac tumor in the seminal vesicle.CaseA 38-year-old Asian male presented with gross hematuria and hemospermia. Transrectal ultrasound scan showed a solid mass in the left seminal vesicle and the scrotal sonography showed no abnormalities. Bilateral seminal vesicles were resected, and histopathological examination showed a typical pattern of yolk sac tumor (YST). The patient responded poorly to comprehensive treatment of radiotherapy, chemotherapy and surgeries, developed systemic multiple metastases, and died of cachexia one and half years after diagnosis.

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Section: Discussionmentioning

confidence: 91%

Primary yolk sac tumor of seminal vesicle: a case report and literature review

Yao

Hong

et al. 2012

World J Surg Onc

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“…We also previously reported the usefulness of HDCT consisting of carboplatin, etoposide and ifosfamide (ICE) combined with PBSCT for advanced metastatic GCT, 6 and this approach has been applied to advanced EGGCT as well. However, to our knowledge, there have been few studies evaluating the efficacy of HDCT against EGGCT; 5,7 accordingly, in this study, we retrospectively reviewed the clinical data of six patients with advanced EGGCT who were treated with first‐line HDCT combined with PBSCT.…”

Section: Introductionmentioning

confidence: 99%

First‐line high‐dose chemotherapy combined with peripheral blood stem cell transplantation for patients with advanced extragonadal germ cell tumors

et al. 2007

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Background: The objective of this study was to evaluate the efficacy and safety of first-line high-dose chemotherapy (HDCT) combined with peripheral blood stem cell transplantation (PBSCT) for patients with advanced extragonadal germ cell tumors (EGGCT). Methods: Six male patients with advanced non-seminomatous EGGCT were treated with HDCT combined with PBSCT following 2-3 cycles of conventional-dose induction chemotherapy. The regimens used for HDCT were carboplatin, etoposide and ifosfamide (ICE) in five patients and ICE plus paclitaxel (T-ICE) in one patient, and that for induction therapy was cisplatin, etoposide and bleomycin (PEB) in all patients. As a rule, HDCT was continuously administered until a-fetoprotein (AFP) and b-human chorionic gonadotropin normalized (b-HCG). Results: Following 1-6 courses of HDCT (median, 4 courses), b-HCG and AFP were normalized in all patients, and five and one patient were diagnosed as showing partial remission and stable disease, respectively. Five patients underwent surgical resection of residual tumors after HDCT, yielding necrotic tissue in two, mature teratoma in two, and viable cancer tissue in one, and the surgical margin was negative in all patients. At a median follow-up of 36 months, five patients were alive and disease-free, whereas the remaining one died of disease progression. Although all patients had grade 3 hematological toxicity, there was no treatment-related death by combining PBSCT. Conclusions: First-line HDCT with PBSCT could be safely administered to patients with advanced EGGCT, and the antitumor effect of this treatment was comparatively favorable. First-line HDCT therefore may represent an attractive option for patients with advanced EGGCT.

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“…The two randomized studies conducted in this patient population (29,30) failed to demonstrate an OS benefit. Albeit supported by limited data, first line "consolidation" HDCT may be considered in selected patients with chemosensitive primary mediastinal disase (31,32). Intensified treatments has been more widely investigated as a salvage therapy for patients with an incomplete response to initial CT and for those with relapsed GCTs.…”

Section: Germ Cell Tumors (Gct)mentioning

confidence: 99%

“…Finally, as observed in the adjuvant setting, also stage IV pts with HER2 positive tumors derive no benefit from high-dose alkylating agents (19). It requires to be demonstrated whether the use of non-alkylating drugs, including taxanes, antracycline and mitoxantrone (24,32), in HDC regimens might prove effective in subset of pts with HER2 positive or with other biological tumor characteristics (29). Also in the setting of metastatic disease, randomized studies in selected patient populations are necessary to define the exact role of HDC.…”

Section: Metastatic Bcmentioning

confidence: 99%