High dose chemotherapy and autologous stem cell transplantation for salvage therapy of relapsed /refractory germ cell tumors; a single center experience.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-04-05 DOI:10.1159/000538660

Gul Sema Yıldıran Keskin, İ. Ertürk, M. Aykan, R. Acar, Aysegul Dumludag, Alper Topal, Caglar Koseoglu, Omer Faruk Kuzu, Ece Ornek, N. Karadurmuş

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引用次数: 0

Abstract

PURPOSE The optimal management of relapsed/refractory germ cell tumors remains unsettled. In this study, we aimed to evaluate the efficacy of high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT) as salvage therapy in patients who progressed after at least one line of cisplatin-based chemotherapy. METHODS We retrospectively reported the results of 133 patients who underwent HDCT and ASCT as salvage therapy from 2016 to 2021. Patients received 3 cycles of paclitaxel, ifosfomide and cisplatin (TIP) regimen as induction and 1 cycle of carboplatin 700 mg/m2 on days 1 to 3 plus etoposide 750 mg/m2 on days 1 to 3, followed by ASCT. Demographic and clinicopathological features of patients, the International Germ Cell Cancer Collaborative Group (IGCCCG) risk group at diagnosis, serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (HCG) levels before HDCT, treatment related complications and survival outcomes were recorded. RESULTS The median age of the patients was 31 (range 18-62). The median follow-up was 31.1 months (95% CI, 28.9 to 33.3 months). During the median follow-up period, 74 of the 133 patients were still alive, and 63 of these were in complete remission. The median progression-free survival (PFS) was 25.8 months (95% CI, 8.1-43.4 months). The 2-year PFS rate was 50.3% and the 2-year overall survival rate was 60.8%. Variables that remained statistically significant in multivariable analysis and were associated with poor prognosis were mediastinal primary tumor location, presence of brain metastases, and higher AFP and HCG levels at baseline. CONCLUSION One course of HDCT and ASCT after induction with TIP is an effective and feasible treatment option for salvage treatment of relapsed/refractory germ cell tumors, with cure rates of up to 60%.

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大剂量化疗和自体干细胞移植用于复发/难治性生殖细胞肿瘤的挽救治疗；单中心经验。

目的：复发/难治性生殖细胞肿瘤的最佳治疗方法仍未确定。在这项研究中，我们旨在评估高剂量化疗（HDCT）和自体干细胞移植（ASCT）作为至少一线顺铂化疗后进展患者的挽救疗法的疗效。患者接受3个周期的紫杉醇、伊福米特和顺铂（TIP）方案作为诱导治疗，1个周期的卡铂700 mg/m2（第1至3天）加依托泊苷750 mg/m2（第1至3天），然后进行ASCT。记录了患者的人口学和临床病理学特征、诊断时的国际生殖细胞癌症协作组（IGCCCG）风险组别、HDCT前的血清甲胎蛋白（AFP）和β-人绒毛膜促性腺激素（HCG）水平、治疗相关并发症和生存结果。中位随访时间为 31.1 个月（95% CI，28.9 至 33.3 个月）。在中位随访期间，133 名患者中有 74 人仍然存活，其中 63 人病情完全缓解。中位无进展生存期（PFS）为25.8个月（95% CI，8.1-43.4个月）。2年无进展生存率为50.3%，2年总生存率为60.8%。结论在TIP诱导后进行一个疗程的HDCT和ASCT是治疗复发/难治性生殖细胞肿瘤的有效可行的挽救性治疗方案，治愈率高达60%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.