866P - High-Dose Chemotherapy and Autologous Blood Stem Cell Transplantation in Refractory/Metastatic Non-Seminomatous Germ Cell Tumors: Gata Single Center Results

Abstract

ABSTRACT Introduction Some patients with testis cancers do not respond to standard combination chemotherapy and high-dose chemotherapy (HDC) with autologous stem cell transplantation (OSCT) as salvage therapy can achieve a complete remission in these patients. Materials and methods 62 patients that received HDC and OSCT between February 1993 – December 2011 were retrospectively evaluated. Results Median age was 24 (22-32 years). 56 patients (90.3%) had stage III, 6 (9.6%) had stage II disease. Histopathologically, embryonal carcinoma (64%), yolk-sac (24%) and choriocarcinoma (23%) were present. The primary tumor location was testis in 51 patients (82.2%), and 11 patients (17.7%) had extragonadal region origin [6 patients retroperitoneal (9.6%), 5 patients (8.1%) mediastinal]. Evaluation of metastatic focuses was as follows: liver (n = 20, 32.2%), extrahepatic (bone, lung) involvement (n = 34, 54.8%) and central nervous system involvement (n = 5, 8.1%). Six patients with stage II had refractory-high tumor markers and were treated with at least two different lines of chemotherapy, underwent later HDC and OSCT. Two patients with stage II and 16 patients with stage III disease underwent further RPLND. HDC included ifosfamide, carboplatin, etoposide. Median follow-up was 39 (6-54) months. Pre-OSCT median AFP, β-HCG and LDH were 176 IU / ml (4.9-624), 1090 IU / ml (0.6-72000), 346 IU / ml (126–764), respectively; while on 3rd month of OSCT median AFP, β-hCG and LDH were 20 IU / ml (4–54), 4 IU / ml (0.2-20), 124 IU / ml (102-240), respectively. After HDC, 16 patients (25.8%) achieved CR, 21 patients (33.8%) had PR, 8 patients (12.9%) had SD and 17 patients (27.4%) had PD. Three-year OS rate was 41%. The median neutrophil and platelet engraftment time was 14 days (12–17) and 15 days (13–17). The most important treatment toxicity was nephrotoxicity (grade 1/2) (11.2%). Conclusions OSCT with HDC is an effective and curative treatment option in 26% of cases of refractory/metastatic germ cell testicular cancers. Disclosure All authors have declared no conflicts of interest.