Efficacy and safety of high-dose chemotherapy as the first or subsequent salvage treatment line in patients with relapsed or refractory germ cell cancer

• Verfasst von: Seidel, Christoph [VerfasserIn]
• Verfasst von: Schaefers, C. [VerfasserIn]
• Verfasst von: Connolly, E. A. [VerfasserIn]
• Verfasst von: Weickhardt, A. [VerfasserIn]
• Verfasst von: Grimison, P. [VerfasserIn]
• Verfasst von: Wong, V. [VerfasserIn]
• Verfasst von: De Giorgi, U. [VerfasserIn]
• Verfasst von: Hentrich, M. [VerfasserIn]
• Verfasst von: Zschäbitz, Stefanie [VerfasserIn]
• Verfasst von: Ochsenreither, S. [VerfasserIn]
• Verfasst von: Vincenzi, B. [VerfasserIn]
• Verfasst von: Oing, C. [VerfasserIn]
• Verfasst von: Bokemeyer, C. [VerfasserIn]
• Verfasst von: Engel, N. [VerfasserIn]
• Verfasst von: Alsdorf, W. [VerfasserIn]
• Verfasst von: Tran, B. [VerfasserIn]
• Titel: Efficacy and safety of high-dose chemotherapy as the first or subsequent salvage treatment line in patients with relapsed or refractory germ cell cancer
• Titelzusatz: an international multicentric analysis
• Verf.angabe: C. Seidel, C. Schaefers, E.A. Connolly, A. Weickhardt, P. Grimison, V. Wong, U. De Giorgi, M. Hentrich, S. Zschäbitz, S. Ochsenreither, B. Vincenzi, C. Oing, C. Bokemeyer, N. Engel, W. Alsdorf & B. Tran
• E-Jahr: 2024
• Jahr: 13 May 2024
• Umfang: 6 S.
• Illustrationen: Illustrationen
• Fussnoten: Online verfügbar: 13. Mai 2024, Artikelversion: 13. Mai 2024 ; Gesehen am 05.12.2024
• Titel Quelle: Enthalten in: ESMO open
• Ort Quelle: [London] : Elsevier, 2016
• Jahr Quelle: 2024
• Band/Heft Quelle: 9(2024), 5 vom: Mai, Artikel-ID 103449, Seite 1-6
• ISSN Quelle: 2059-7029
• DOI: doi:10.1016/j.esmoop.2024.103449
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: conventional-dose salvage regimens
• Sach-SW: high-dose chemotherapy
• Sach-SW: refractory germ cell tumor
• Sach-SW: relapse
• Sach-SW: salvage chemotherapy
• K10plus-PPN: 1910961205

Abstract

Background - In relapsed or refractory (RR) metastatic germ cell cancer (GCC), high-dose (HD) chemotherapy (CTX) plus autologous stem cell transplantation is considered the standard of care. Limited data exist regarding the efficacy of HD-CTX following conventionally dosed salvage regimens (CDRs). This analysis explores and contrasts the efficacy of HD-CTX as the first or subsequent salvage regimen. - Patients and methods - Data were retrospectively collected to explore the efficacy of HD-CTX administered as the first (group A) or subsequent salvage CTX (group B) after a CDR. The primary endpoint was OS from the time of HD-CTX. Associations of survival, overall response rate (ORR), and toxicity with clinical characteristics were explored using stratified Kaplan-Meier and Cox regression models. - Results - Overall, 283 patients with GCC were included from 11 international centers, with 159 patients (56%) in group A and 124 patients (44%) in group B. The first salvage treatment was administered between 1998 and 2022, with a median follow-up of 27.0 [standard deviation (SD) 46.2] months for group A and 17.0 (SD 48.5) months for group B. The median OS from HD-CTX treatment initiation was not reached in group A, compared with 25 months in group B (P = 0.00027), associated with 2- and 5-year OS rates of 74% and 63% (group A) versus 53% and 37% (group B), respectively. When administered as the first salvage treatment, HD-CTX was associated with a higher ORR (79% versus 60%; P = 0.013) and lower nonhematologic grade ≥3 toxicity rate (78% versus 97%; P < 0.001). Concerning risk factor analysis for the total cohort, the International Prognostic Factors Study Group score was the only independent predictor of OS in multivariable analysis (P = 0.006). - Conclusions - When administered as the initial salvage treatment or after CDR, HD-CTX exhibits curative potential for patients with RR GCC. The efficacy and safety outcomes were more favorable when HD-CTX was conducted as the first salvage treatment line.