Salvage high-dose chemotherapy in female patients with relapsed/refractory germ-cell tumors: A retrospective analysis of the European Group for Blood and Marrow Transplantation (EBMT)

Ugo De Giorgi, S. Richard, M. Badoglio, E. Kanfer, J. H. Bourrhis, E. Nicolas-Virelizier, K. Vettenranta, B. Lioure, S. Martin, P. Dreger, M. K. Schuler, K. Thomson, E. Scarpi, G. Rosti, F. Selle, G. Mangili, F. Lanza, M. Bregni, on behalf of the Solid Tumours Working Party (STWP) of the EBMT

Research output: Contribution to journalArticlepeer-review

Abstract

Background: High-dose chemotherapy (HDC) with hematopoietic progenitor cell transplantation is a standard option for relapsed/refractory testicular germ-cell tumor (GCT), but only few data have been reported in female patients with GCT. We conducted a retrospective analysis of female patients with GCT treated with HDC and registered with the European Society for Blood and Marrow Transplantation. Patients and methods: Between 1985 and 2013, 60 registered female patients with GCT, median age 27 years (range 15-48), were treated with salvage HDC. Forty patients (67%) had primary ovarian GCT, 8 (13%) mediastinal, 7 (12%) retroperitoneal and 5 (8%) other primary sites/unknown. Twenty-two patients (37%) received HDC as second-line therapy, 29 (48%) as third-line, and 9 (15%) as fourth- to sixth-line. Nine of 60 patients (15%) received HDC as late-intensification with no evidence of metastasis before HDC. The conditioning HDC regimens comprised carboplatin in 51 of 60 cases (85%), and consisted of a single HDC cycle in 31 cases (52%), a multi-cycle HDC regimen in 29 (48%). Results: Nine cases who underwent late intensification HDC were not evaluable for response. Of the other 51 assessable patients, 17 (33%) achieved a complete response (CR), 8 (16%) a marker-negative partial remission (PRm-), 5 (10%) a marker-positive partial remission, 5 (10%) stable disease, and 13 (25%) progressive disease. There were 3 toxic deaths (6%). With an overall median follow-up of 14 months (range 1-219), 7 of 9 (78%) patients with late intensification and 18 of the 25 patients (72%) achieving a CR/PRm- following HDC were free of relapse/progression. In total, 25 of 60 patients (42%) were progression-free following HDC at a median follow-up of 87 months (range 3-219 months). Conclusions: Salvage HDC based on carboplatin represents a therapeutic option for female patients with relapsed/refractory GCT.

Original languageEnglish
Article numbermdx259
Pages (from-to)1910-1916
Number of pages7
JournalAnnals of Oncology
Volume28
Issue number8
DOIs
Publication statusPublished - Aug 1 2017

Keywords

  • Female
  • Germ-cell tumors
  • High-dose chemotherapy
  • Refractory
  • Relapsed
  • Salvage therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

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