Efficacy and safety of high-dose chemotherapy as the first or subsequent salvage treatment line in patients with relapsed or refractory germ cell cancer: an international multicentric analysis
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). T...
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| Hauptverfasser: | , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
13 May 2024
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| In: |
ESMO open
Year: 2024, Jahrgang: 9, Heft: 5, Pages: 1-6 |
| ISSN: | 2059-7029 |
| DOI: | 10.1016/j.esmoop.2024.103449 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.esmoop.2024.103449 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2059702924012171 
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| Verfasserangaben: | 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 |
MARC
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| 245 | 1 | 0 | |a Efficacy and safety of high-dose chemotherapy as the first or subsequent salvage treatment line in patients with relapsed or refractory germ cell cancer |b an international multicentric analysis |c 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 |
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| 500 | |a Online verfügbar: 13. Mai 2024, Artikelversion: 13. Mai 2024 | ||
| 500 | |a Gesehen am 05.12.2024 | ||
| 520 | |a 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. | ||
| 650 | 4 | |a conventional-dose salvage regimens | |
| 650 | 4 | |a high-dose chemotherapy | |
| 650 | 4 | |a refractory germ cell tumor | |
| 650 | 4 | |a relapse | |
| 650 | 4 | |a salvage chemotherapy | |
| 700 | 1 | |a Schaefers, C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Connolly, E. A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Weickhardt, A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Grimison, P. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Wong, V. |e VerfasserIn |4 aut | |
| 700 | 1 | |a De Giorgi, U. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Hentrich, M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Zschäbitz, Stefanie |d 1983- |e VerfasserIn |0 (DE-588)1037698827 |0 (DE-627)75589894X |0 (DE-576)391727206 |4 aut | |
| 700 | 1 | |a Ochsenreither, S. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Vincenzi, B. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Oing, C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bokemeyer, C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Engel, N. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Alsdorf, W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Tran, B. |e VerfasserIn |4 aut | |
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