Vinblastine monotherapy induction prior to radiotherapy for patients with intracranial germinoma during the COVID-19 pandemic.


Journal

Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624

Informations de publication

Date de publication:
01 2022
Historique:
revised: 02 09 2021
received: 30 06 2021
accepted: 05 09 2021
pubmed: 15 9 2021
medline: 24 12 2021
entrez: 14 9 2021
Statut: ppublish

Résumé

Patients with localized intracranial germinoma have excellent survival. Reducing treatment burden and long-term sequelae is a priority. Intensive inpatient chemotherapy (e.g., carboPEI = carboplatin/etoposide/ifosfamide) has been effectively employed to reduce radiotherapy treatment volume/dose. Outpatient-based carboplatin monotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology), and successful vinblastine monotherapy induction (with 77% tumor volume reduction after just two weekly vinblastine doses) has recently been reported in an intracranial germinoma patient. Adapted UK guidelines for germ cell tumor management were distributed during the COVID-19 pandemic, including nonstandard treatment options to reduce hospital visits and/or admissions. This included vinblastine monotherapy for intracranial germinoma (6 mg/m A 30-year-old male with a localized pineal tumor received 12-week vinblastine induction, with >60% volume reduction, prior to definitive radiotherapy. A 12-year-old female with a metastatic suprasellar tumor and progression at all sites of disease whilst awaiting proton radiotherapy received two vinblastine doses with good early response, including 36% primary tumor volume reduction. The patients tolerated vinblastine well. Patients with intracranial germinoma have excellent outcomes, and reduction of late effects remains a priority. The description of vinblastine monotherapy in these intracranial germinoma patients warrants further exploration.

Sections du résumé

BACKGROUND
Patients with localized intracranial germinoma have excellent survival. Reducing treatment burden and long-term sequelae is a priority. Intensive inpatient chemotherapy (e.g., carboPEI = carboplatin/etoposide/ifosfamide) has been effectively employed to reduce radiotherapy treatment volume/dose. Outpatient-based carboplatin monotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology), and successful vinblastine monotherapy induction (with 77% tumor volume reduction after just two weekly vinblastine doses) has recently been reported in an intracranial germinoma patient.
METHODS
Adapted UK guidelines for germ cell tumor management were distributed during the COVID-19 pandemic, including nonstandard treatment options to reduce hospital visits and/or admissions. This included vinblastine monotherapy for intracranial germinoma (6 mg/m
RESULTS
A 30-year-old male with a localized pineal tumor received 12-week vinblastine induction, with >60% volume reduction, prior to definitive radiotherapy. A 12-year-old female with a metastatic suprasellar tumor and progression at all sites of disease whilst awaiting proton radiotherapy received two vinblastine doses with good early response, including 36% primary tumor volume reduction. The patients tolerated vinblastine well.
CONCLUSION
Patients with intracranial germinoma have excellent outcomes, and reduction of late effects remains a priority. The description of vinblastine monotherapy in these intracranial germinoma patients warrants further exploration.

Identifiants

pubmed: 34520101
doi: 10.1002/pbc.29359
pmc: PMC8662027
doi:

Substances chimiques

Vinblastine 5V9KLZ54CY
Etoposide 6PLQ3CP4P3
Carboplatin BG3F62OND5

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e29359

Informations de copyright

© 2021 Wiley Periodicals LLC.

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Auteurs

Matthew J Murray (MJ)

Department of Pathology, University of Cambridge, Cambridge, UK.
Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Rafael Moleron (R)

Department of Clinical Oncology, Aberdeen Royal Infirmary, Aberdeen, UK.

Jennifer Adamski (J)

Department of Paediatric Haematology and Oncology, Birmingham Children's Hospital, Birmingham, UK.

Martin English (M)

Department of Paediatric Haematology and Oncology, Birmingham Children's Hospital, Birmingham, UK.

G A Amos Burke (GAA)

Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Justin Cross (J)

Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Thankamma Ajithkumar (T)

Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Sara Stoneham (S)

Department of Paediatric and TYA Oncology, University College Hospital London, London, UK.

James C Nicholson (JC)

Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

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Classifications MeSH