Current outstanding challenges in germ cell tumors.


Journal

Current opinion in oncology
ISSN: 1531-703X
Titre abrégé: Curr Opin Oncol
Pays: United States
ID NLM: 9007265

Informations de publication

Date de publication:
01 May 2024
Historique:
medline: 4 4 2024
pubmed: 4 4 2024
entrez: 4 4 2024
Statut: ppublish

Résumé

Despite the remarkable advances in the treatment of germ cell tumors (GCT), several challenges remain. This review aims to highlight some of these challenges and provide guidance on how to navigate through them. Patients with International Germ Cell Cancer Collaborative Group poor risk disease have worse prognosis and investigating novel therapeutic interventions are warranted in this population. Patients with brain metastases require a multidisciplinary approach by a group of clinicians experienced in the management of germ cell tumors. Patients with platinum refractory disease have poor prognosis and development of novel treatment options is urgently needed. Conventional tumor markers including alpha fetoprotein and human chorionic gonadotropin remain standard. Development of novel biomarkers to detect minimal residual disease or teratoma is needed. Management of patients with GCT requires a multidisciplinary approach. Patients should preferably be evaluated at tertiary care centers with expertise in the management of this disease.

Identifiants

pubmed: 38573206
doi: 10.1097/CCO.0000000000001026
pii: 00001622-202405000-00009
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

169-173

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Références

Miller KD, Fidler-Benaoudia M, Keegan TH, et al. Cancer statistics for adolescents and young adults, 2020. CA Cancer J Clin 2020; 70:443–459.
Mead GM. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997; 15:594–603.
van Dijk MR, Steyerberg EW, Habbema JDF. Survival of nonseminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer 2006; 42:820–826.
Adra N, Althouse SK, Liu H, et al. Prognostic factors in patients with poor-risk germ-cell tumors: a retrospective analysis of the Indiana University experience from 1990 to 2014. Ann Oncol 2016; 27:875–879.
Nichols CR, Catalano PJ, Crawford ED, et al. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol 1998; 16:1287–1293.
Murphy BR, Breeden ES, Donohue JP, et al. Surgical salvage of chemorefractory germ cell tumors. J Clin Oncol 1993; 11:324–329.
Loehrer PJ, Lauer R, Roth BJ, et al. Salvage therapy in recurrent germ cell cancer: ifosfamide and cisplatin plus either vinblastine or etoposide. Ann Intern Med 1988; 109:540–546.
Loehrer PJ, Gonin R, Nichols CR, et al. Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol 1998; 16:2500–2504.
Kondagunta GV, Bacik J, Donadio A, et al. Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol 2005; 23:6549–6555.
Feldman DR, Sheinfeld J, Bajorin DF, et al. TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis. J Clin Oncol 2010; 28:1706–1713.
Einhorn LH, Williams SD, Chamness A, et al. High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. N Engl J Med 2007; 357:340–348.
Daugaard G, Skoneczna I, Aass N, et al. A randomized phase III study comparing standard dose BEP with sequential high-dose cisplatin, etoposide, and ifosfamide (VIP) plus stem-cell support in males with poor-prognosis germ-cell cancer. An intergroup study of EORTC, GTCSG, and Grupo Germinal (EORTC 30974). Ann Oncol 2011; 22:1054–1061.
Motzer RJ, Nichols CJ, Margolin KA, et al. Phase III randomized trial of conventional-dose chemotherapy with or without high-dose chemotherapy and autologous hematopoietic stem-cell rescue as first-line treatment for patients with poor-prognosis metastatic germ cell tumors. J Clin Oncol 2007; 25:247–256.
Nichols CR, Williams SD, Loehrer PJ, et al. Randomized study of cisplatin dose intensity in poor-risk germ cell tumors: a Southeastern Cancer Study Group and Southwest Oncology Group protocol. J Clin Oncol 1991; 9:1163–1172.
Subramaniam S, Toner GC, Stockler MR, et al. P3BEP (ANZUP 1302): an international randomized phase III trial of accelerated versus standard BEP chemotherapy for male and female adults and children with intermediate and poor-risk metastatic germ cell tumors (GCTs). Available at: https://doi.org/101200/JCO2021396_supplTPS390. 2021; 39(Suppl):TPS390.
Oechsle K, Bokemeyer C. Treatment of brain metastases from germ cell tumors. Hematol Oncol Clin North Am 2011; 25:605–613.
Feldman DR, Lorch A, Kramar A, et al. Brain metastases in patients with germ cell tumors: prognostic factors and treatment options—an analysis from the global germ cell cancer group. J Clin Oncol 2016; 34:345–351.
Ashkar R, Althouse SK, Cary C, et al. Prediction model for brain metastasis (BM) in patients with metastatic germ-cell tumors (mGCT) accounting for size of pulmonary metastases. J Clin Oncol 2021; 39: (Suppl): 378–1378.
Gilligan T, Hutchinson Cancer Center F, Aggarwal R, et al. NCCN guidelines version 1.2023. Testicular Cancer Continue NCCN Guidelines Panel Disclosures. Published online 2023. Available at: https://www.nccn.org/home/member- [Accessed November 25, 2023].
Adra N, Abonour R, Althouse SK, et al. High-dose chemotherapy and autologous peripheral-blood stem-cell transplantation for relapsed metastatic germ cell tumors: the indiana university experience. J Clin Oncol 2017; 35:1096–1102.
Taza F, Abonour R, Zaid MA, et al. Maintenance oral etoposide after high-dose chemotherapy (HDCT) for patients with relapsed metastatic germ-cell tumors (mGCT). Clin Genitourin Cancer 2023; 21:213–220.
Feldman DR, Turkula S, Ginsberg MS, et al. Phase II trial of sunitinib in patients with relapsed or refractory germ cell tumors. Invest New Drugs 2010; 28:523–528.
Albany C, Einhorn L, Garbo L, et al. Treatment of CD30-expressing germ cell tumors and sex cord stromal tumors with brentuximab vedotin: identification and report of seven cases. Oncologist 2018; 23:316–323.
Adra N, Einhorn LH, Althouse SK, et al. Phase II trial of pembrolizumab in patients with platinum refractory germ-cell tumors: a Hoosier Cancer Research Network Study GU14-206. Ann Oncol 2018; 29:209–214.
Bagrodia A, Lee BH, Lee W, et al. Genetic determinants of cisplatin resistance in patients with advanced germ cell tumors. J Clin Oncol 2016; 34:4000–4007.
Akel R, Anouti B, Kern S, et al. Comprehensive genomic profiling (CGP) in patients with relapsed/refractory germ cell tumors (GCT). J Clin Oncol 2020; 38: (Suppl): e17053.
[King J, Dropcho S, Beeler S, et al. A phase II trial evaluating the efficacy of cabozantinib in the treatment of patients with refractory germ-cell tumors (GCT). Available at: https://doi.org/101200/JCO2022406_supplTPS428. 2022;40(Suppl):TPS428. doi:10.1200/JCO.2022.40.6_SUPPL.TPS428.
Adra N, Vaughn DJ, Einhorn LH, et al. A phase II study assessing the safety and efficacy of ASP1650 in male patients with relapsed refractory germ cell tumors. Invest New Drugs 2022; 40:1087–1094.
Ehrlich Y, Beck SDW, Ulbright TM, et al. Outcome analysis of patients with transformed teratoma to primitive neuroectodermal tumor. Ann Oncol 2010; 21:1846–1850.
Wei C, Cary C, Masterson TA, et al. Adjuvant chemotherapy with CAV/IE for malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): an institutional analysis from Indiana University. Available at: https://doi.org/101200/JCO20213915_suppl5026. 2021; 39(Suppl):5026. doi:10.1200/JCO.2021.39.15_SUPPL.5026.
Al-Hader AA, Jain A, Al-Nasrallah N, Einhorn LH. Metastatic malignant transformation of teratoma to primitive neuroectodermal tumor (PNET): results with PNET-based chemotherapy. Am J Clin Oncol 2015; 38:364–366.
Dieckmann KP, Radtke A, Geczi L, et al. Serum levels of MicroRNA-371a-3p (M371 Test) as a new biomarker of testicular germ cell tumors: results of a prospective multicentric study. J Clin Oncol 2019; 37:1412–1423.
Nappi L, Thi M, Lum A, et al. Developing a highly specific biomarker for germ cell malignancies: plasma MiR371 expression across the germ cell malignancy spectrum. J Clin Oncol 2019; 37:3090–3098.

Auteurs

Tareq Salous (T)

Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, Indiana, USA.

Classifications MeSH