Managing seminomatous and nonseminomatous germ cell tumors

Chahoud, Jad; Zhang, Miao; Shah, Amishi Yogesh; Lin, Sue Hwa; Pisters, Louis L.; Tu, Shi Ming

doi:10.1097/cco.0000000000000446

Cited by 8 publications

(9 citation statements)

References 64 publications

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“…There are two major types of GCTs, seminomas, and nonseminomas. Nonseminomas consist of embryonal carcinoma (EC), yolk sac tumor, choriocarcinoma, and teratoma 9 . EC are the putative stem cells of GCTs which are derived from primordial germ cells 10 .…”

Section: Introductionmentioning

confidence: 99%

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A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

et al. 2020

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Purpose Germ cell tumors (GCTs) are cured with therapy based on cisplatin, although a clinically significant number of patients are refractory and die of progressive disease. Based on preclinical studies indicating that refractory testicular GCTs are hypersensitive to hypomethylating agents (HMAs), we conducted a phase I trial combining the next‐generation HMA guadecitabine (SGI‐110) with cisplatin in recurrent, cisplatin‐resistant GCT patients. Methods Patients with metastatic GCTs were treated for five consecutive days with guadecitabine followed by cisplatin on day 8, for a 28‐day cycle for up to six cycles. The primary endpoint was safety and toxicity including dose‐limiting toxicity (DLT) and maximum tolerated dose (MTD). Results The number of patients enrolled was 14. The majority of patients were heavily pretreated. MTD was determined to be 30 mg/m2 guadecitabine followed by 100 mg/m2 cisplatin. The major DLTs were neutropenia and thrombocytopenia. Three patients had partial responses by RECIST criteria, two of these patients, including one with primary mediastinal disease, completed the study and qualified as complete responses by serum tumor marker criteria with sustained remissions of 5 and 13 months and survival of 16 and 26 months, respectively. The overall response rate was 23%. Three patients also had stable disease indicating a clinical benefit rate of 46%. Conclusions The combination of guadecitabine and cisplatin was tolerable and demonstrated activity in patients with platinum refractory germ cell cancer.

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Section: Introductionmentioning

confidence: 99%

“…Nonseminomas consist of embryonal carcinoma (EC), yolk sac tumor, choriocarcinoma, and teratoma. 9 EC are the putative stem cells of GCTs which are derived from primordial germ cells. 10 Generally, the DNA of testicular germ cell tumors (TGCTs) is less methylated compared to other cancers, especially seminomas.…”

Section: Introductionmentioning

confidence: 99%

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

et al. 2020

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“…Los linfomas representan 20 % de todas las neoplasias mediastinales en los adultos y 50 % en los niños 20,21 . Los tumores de células germinales del mediastino constituyen 10-15 % de los tumores mediastinales, y esos mismos porcentajes de las tumores mediastinales anteriores [22][23][24][25][26][27] . Los quistes mediastinales causan 20-32 % de los tumores mediastinales primarios, y entre ellos, los quistes broncogénicos representan 50-60 % 28,29 .…”

Section: Algunos Aspectos Clínicoepidemiológicosunclassified

Consideraciones en torno a los tumores del mediastino

et al. 2020

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Introducción. El desarrollo de las imágenes diagnósticas hizo posible el diagnóstico topográfico de los tumores de mediastino; sin embargo, aún con los avances actuales de la cirugía, la anestesiología y la reanimación, el acceso quirúrgico a ese espacio medio de la caja torácica continúa siendo el gran reto que enfrentan los cirujanos torácicos. Objetivo. Profundizar en los diferentes aspectos cognoscitivos actualizados sobre los tumores mediastinales. Métodos. Búsqueda documental digital en bases de datos: Scielo, Lilacs, Web of Science, PubMed, realizada en enero de 2019, de publicaciones sobre el tema en la presente centuria. Resultados. Las neoplasias mediastinales son poco frecuentes, pueden aparecer a cualquier edad, aunque son más frecuentes entre la tercera y quinta décadas, y la mayoría se descubren incidentalmente en una radiografía de tórax de rutina en pacientes asintomáticos. Los tumores malignos del mediastino son poco frecuentes, pero los benignos constituyen un desafío diagnóstico para radiólogos y patólogos. En las neoplasias malignas se identifica una amplia gama de variedades histológicas, atribuibles a las características del órgano afectado. Conclusiones. El diagnóstico definitivo generalmente se establece mediante el estudio histopatológico posquirúrgico, si bien la tomografía computarizada, asociada o no a la biopsia percutánea, es el estándar de oro para el diagnóstico preoperatorio. La selección de la vía de entrada al tórax, así como el procedimiento quirúrgico, están condicionados por la localización y el tamaño del tumor en el mediastino.

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“…Histologically, pure seminomas account for approximately 60% of TCs. Treatments for testicular seminoma (TS) have been continuously improving over the years due to a series of advancements in therapeutic regimens 2. Most patients with seminoma can be treated with orchiectomy and, if necessary, subsequent chemotherapy or radiotherapy can be provided 3,4.…”

Section: Introductionmentioning

confidence: 99%

“…Most patients with seminoma can be treated with orchiectomy and, if necessary, subsequent chemotherapy or radiotherapy can be provided 3,4. Although accurate diagnosis and advanced multimodal treatment significantly contribute to good prognosis, some controversies regarding the different side effects of post-orchiectomy therapeutic regimens for the treatment of TS still exists 2–6…”

Section: Introductionmentioning

confidence: 99%

<p>Clinical characteristics of testicular seminoma in individuals in West China: a 10-year follow-up study</p>

Chen

Qiu

Cao

et al. 2019

CMAR

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Objective To assess the clinical characteristics of testicular seminoma (TS). Patients and methods A testicular cancer (TC) survey was conducted by the Department of Urology, West China Hospital, between 2008 and 2018. Tumors were classified according to the NCCN criteria such as age, tumor size, tumor marker levels, histopathology, clinical stage, initial treatment, follow-up, and clinical outcomes, were obtained from the database of our center. Results Among 155 registered cases of TC with seminomatous element, 127 cases of pure TS were analyzed. All 127 patients with a median age of 37 years were pathologically diagnosed with orchiectomy specimens. Orchiectomy, chemotherapy, and radiotherapy were the main treatments for these patients. Patients with clinical stages I, II, and III testicular cancer of accounted for 81.1% (n=103), 15.7% (n=20), and 3.2% (n=4) of all patients, respectively. After a median follow-up time of 50 months, five patients presented with relapse during follow-up, and one among them died. Of the patients with stage I TS (T1N0M0S0 CS IA), three patients who only underwent orchiectomy relapsed. Among patients with stage II TS (T1N1M0S1 CS IIA), one patient relapsed after orchiectomy, post-surgery chemotherapy and radiotherapy. In four patients with stage III disease (T2N1M1aS1 CS IIIA), one relapsed after orchiectomy and chemotherapy, and died shortly after salvage chemotherapy and radiotherapy due to recurrence. The median overall survival time was 50 months. In all patients, the 2-year overall survival and progression-free survival probabilitis were 98.6% and 98.8%, respectively. Conclusion The present study shows that patients with TS have good prognosis even at an advanced stage. Surveillance after orchiectomy was important for patients with CSI seminoma, and we recommend cisplatin-based chemotherapy as salvage therapy for patients with CSI seminoma. In addition, patients with a maximal tumor diameter >4 cm should undergo post-surgery chemotherapy.

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Managing seminomatous and nonseminomatous germ cell tumors

Abstract: Remaining challenges to be addressed include minimizing therapeutic toxicity, and improving outcomes in patients with refractory/recurrent GCTs.

Cited by 8 publications

References 64 publications

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

Consideraciones en torno a los tumores del mediastino

<p>Clinical characteristics of testicular seminoma in individuals in West China: a 10-year follow-up study</p>

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