Is the blood-brain barrier relevant in metastatic germ cell tumors?

Abstract

15618 Background: Metastatic germ cell tumors (GCT) are highly curable. Central Nervous System (CNS) recurrence can terminate a complete remission in other chemosensitive tumors such as small cell lung cancer due to the blood brain barrier (BBB). We document that the BBB can also be relevant in GCTs despite dramatic chemosensitivity. Methods: We present five cases of CNS only relapse in GCTs. None of these five patients had CNS metastases at the start of chemotherapy. Results: We have identified five unique patients from our large series of metastatic testicular cancer patients treated with chemotherapy. These patients were rendered free of disease with cisplatin- based chemotherapy only to relapse in the brain alone ( Table 1 ). This included one patient with good risk disease by the International Germ Cell Collaborative Group staging system (Patient #5). All patients had pulmonary metastases at diagnosis and a component of embryonal carcinoma. Three patients are alive without evidence of disease (NED) at 19, 32 and 8 months. One patient died of his disease (DOD) and one patient is alive with disease (AWD). Conclusion: The blood brain barrier is relevant in metastatic testicular cancer. [Table: see text] No significant financial relationships to disclose.