Adaptation of chemotherapy to the decline tumor markers in patients with poor prognosis nonseminomatous germ cell tumors:Real-world French experience.

Authors

null

Marion Rolland

MD, Toulouse, France

Marion Rolland , Sara Faouzi , Leonor Chaltiel , Clement Dumont , Lionnel Geoffrois , Marine Gross-Goupil , Brigitte Laguerre , Mathilde Guerin , Ludovic Doucet , Guilhem Roubaud , Magalie Tardy , Stephane Oudard , Aude Flechon , Diego Tosi , Hakim Mahammedi , Christine Chevreau , Damien Pouessel , Karim Fizazi

Organizations

MD, Toulouse, France, Gustave Roussy Institute and University of Paris Saclay, Villejuif, France, Institut Claudius Regaud/IUCT-Oncopole, Toulouse, France, Department of Oncology, Saint-Louis Hospital, AP-HP, Paris, France, Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-Lès-Nancy, France, Bergonie Institute, Cancer Center, Bordeaux, France, Centre Eugène Marquis, Rennes, France, Centre Paoli-Calmettes, Marseille, France, ICO, Nantes Saint-Herblain, France, Institut Bergonié, Bordeaux, France, Centre Lacassagne, Nice, France, Georges Pompidou Hospital, University of Paris, Paris, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France, Medical Oncology Department, Institut du Cancer de Montpellier, Montpellier, France, Centre Jean Perrin, Clermont-Ferrand, France, IUCT-Oncopôle Institut Claudius Regaud, Toulouse, France, Institut Gustave Roussy and University of Paris Sud, Villejuif, France

Research Funding

No funding received
None.

Background: Personalized chemotherapy based on tumor marker decline is the new standard in poor prognosis germ-cell tumor in Europe since 2014 (GETUG 13, Lancet, Fizazi et al). The purpose of this study was to analyze the reproducibility of the princeps study in patients not selected in clinical routine between 2014 and 2018. Methods: Patients (pts) were eligible if they had at least one criteria of IGCCCG classification for poor prognosis group. They had to be treated according the study terms of GETUG 13 study and did not received prior treatment. They had to received 1 BEP (Bleomycin, Etoposide, Cisplatin). Tumor markers (HCG and AFP) were dosed between day 18 and 21. Then, they received 3 additional BEP if they had favorable tumor marker decline or intensive chemotherapy if they had unfavorable decline. Results: This retrospective study included 104 patients in 14 french centers treated between 2013 and 2018: 22,1 % (n = 23) in the favorable group (Fav), 77,9 % (n = 81) in the unfavorable group (Unfav). Thirty-two pts had PS ≥ 2. In Unfav, there were more pts with HCG > 50 000 UI/L (44,2 % vs 13 %, p = 0,0067), neutrophil-to-lymphocyt ratio was also higher (median 6,4 vs 4,5, p = 0,0199). At cycle 1, all pts received BEP in Fav and 87,5 % (n = 70) in Unfav. After chemotherapy and surgery, 65,2 % in Fav and 41,3 % in Unfav obtained complete response. At 30 months (median follow-up), Fav-OS was 80,5 % (IC95% 55,8 – 92,2) and Unfav-OS was 64,4 % (IC95% 52 – 74,4). At 30 months, rates were 69,6 % (IC95% 46,6 -84,2) and 63.5 % (IC95% 51,9 – 73) respectively. In GETUG 13 study, 3-years OS was 84 % in Fav and 73 % on Unfav; 3-years PFS was 70 % and 59 % respectively. Seven pts died because of toxicity in Unfav (No one in Fav). Neuropathy, anemia and thrombopenia were more frequent in Unfav. Salvage high-dose chemotherapy with stem-cell transplant was required in 4 (66,7 %) pts in Fav and 8 (36,4 %) pts in Unfav. Conclusions: This study showed a reproducibility of the princeps study in terms of PFS and OS. Toxicity seemed more important in real world. For the congress, results will be reported with 50 additional pts.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2021 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session: Adrenal, Penile, Testicular, and Urethral Cancers

Track

Adrenal Cancer,Penile Cancer,Testicular Cancer,Urethral Cancer

Sub Track

Symptoms, Toxicities, and Whole-Person Care

Citation

J Clin Oncol 39, 2021 (suppl 6; abstr 385)

DOI

10.1200/JCO.2021.39.6_suppl.385

Abstract #

385

Poster Bd #

Online Only

Abstract Disclosures