860P - Experience with First Salvage Veip in Germ Cell Tumor Patients

Abstract

ABSTRACT Introduction Despite cisplatin-etoposide based induction chemotherapy, 20-30% of germ cell tumor (GCT) patients will require salvage treatment. Cisplatin-ifosfamide based salvage regimen produces durable remission at the cost of severe toxicity. In this study, we report our experience with first salvage chemotherapy. Material and methods Medical records of patients receiving first salvage chemotherapy with vinblastine 0.11mg/kg iv d1-d2, ifosfamide 1200mg/m2 iv d1-d5 and cisplatin 20mg/m2 iv d1-d5 (VeIP) for GCT was reviewed. Those who continued to respond were given more than 4 cycles of chemotherapy. Overall response rate (ORR) was assessed by CT and/or MRI scans using WHO response criteria at the completion of chemotherapy. Results From April 2006 to April 2011, 350 patients of GCT were treated at Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore (Pakistan). Out of those 350 patients, 34 were treated with VeIP chemotherapy as first salvage for primary progressive (n = 2) or relapsed (n= 32) GCT (non-seminoma = 30; seminoma = 4). Thirty three patients were male and only 1 was female. Median age at the time of diagnosis was 26 years (range from 17 to 58) and most (54.3%) had poor prognostic features according to IGCCC. Median time of relapse after primary induction chemotherapy was 8.067 months (95% CI 6.491 to 9.642). Median of 4 cycles salvage VeIP were administered (range 1-6 cycles). One patient died during salvage chemotherapy due to sepsis. Response assessment was possible in 29 patients. ORR was 31.4% (CR = 6.7% and PR = 30.0%), SD in 26.7% and PD in 36.7% patients. Surgical resection of residual mass was not possible in any of our patients. Three patients were further treated with radiation therapy. Twenty patients continued follow up (median 1.93 years; from 0.51 to 4.9) after completion of VeIP. At the time of analysis, 6 patients died and 21 were alive. Median PFS after VeIP was 6.033 months (3.608 to 8.459) while median OS had not yet reached. Conclusions VeiP showed radiologic shrinkage of tumor in one-third of our patients and resulted in reasonably long survival of our high risk relapsed patients. Our results were comparable with International data. Disclosure All authors have declared no conflicts of interest.