ASCO 2018: Approaches in Management of Refractory Germ Cell Cancer

Chicago, IL (UroToday.com) Anja Lorch, MD, gave a talk on how to approach and treat refractory germ cell tumors (GCTs). Most patients with metastatic GCTs will be cured by 3-4 cycles of BEP chemotherapy. However, some patients will be refractory to this treatment. For these patients, 1st line salvage therapy has a favorable response in 60-80% of patients, with long-term survival ranging between 30-70%. In 2nd  line salvage treatment, favorable response are seen in 30-40% of patients with long-term survival ranging between 15-25%.

ASCO 2018: Survivorship and Surveillance in Management of Germ Cell Cancer

Chicago, IL (UroToday.com) Christian Kollmannsberger, MD, gave an excellent talk on survivorship and long-term surveillance in the management of germ cell tumors (GCTs). All major types of cancer therapy can result in side effects that can impair well-being, physical and psychosocial functioning, and overall quality of life. These side effects may last long after the treatment ends. In GCTs the late effects affecting mortality do not show until 20+ years of follow-up.  Ironically, the mortality from long-term complications in good/intermediate risk patients may be higher than the mortality associated with the disease itself. In fact, 20 years after cisplatin-based chemotherapy, patients have a 50% higher risk of dying from unrelated GCT causes compared to the general population.[1]

ASCO 2018: State-of-the-Art Management of Germ Cell Cancer

Chicago, IL (UroToday.com) Darren Feldman, MD, gave an outstanding talk on practical points in the management of germ cell tumors (GCTs). Despite an increasing incidence and the fact that it is the most common cancer in men aged 15-24, GCT remains a rare disease. It is the rarity of this disease that increases the risks of errors being made. Additionally, it is noteworthy that in the last 15 years no new drugs have been approved for GCT treatment.

In this talk, Dr. Feldman reviewed some common and important principles and pitfalls in diagnosis and workup, early-stage disease, and advanced disease.

ASCO 2018: Multicenter Randomized Phase 2 Trial of Paclitaxel, Ifosfamide, and Cisplatin Versus Bleomycin, Etoposide, and Cisplatin for First-line Treatment of Patients with Intermediate- or Poor-risk Germ Cell Tumors

Chicago, IL (UroToday.com) Approximately 50% of poor risk and 75% of intermediate risk germ cell tumor (GCT) patients are cured with 1st line bleomycin, etoposide, and cisplatin (BEP). Paclitaxel, Ifosfamide, and cisplatin (TIP) is a standard regimen for GCT patients requiring salvage chemotherapy with 70% complete response (CR) rate, 63% progression free survival (PFS) among relapsed GCT patients. A multicenter single arm phase 2 study published in the Journal of clinical oncology in 2016 demonstrated that TIP as first line therapy in poor- and intermediate-risk GCT patients, had a better response when compared to the historic standard of care of BEP, for poor- and intermediate- risk GCTs.[1] In this study TIP had an acceptable safety profile. The authors therefore, performed this randomized phase 2 study of TIP vs. BEP conducted across 7 centers.

ASCO 2018: Circulating miR-371a-3p for the Detection of Low Volume Viable Germ Cell Tumor: Expanded Pilot Data, Clinical Implications and Future Study

Chicago, IL (UroToday.com) Testicular cancer remains a highly curable disease with an established treatment algorithm. However, there are a subset of patients with recurrent disease for whom management can result in significant clinical impact – overtreatment in this population has important long-term complications, as many of these patients are young me with long life expectancy.