To date, no successful clinical trials of molecular targeted agents in patients with advanced GCT were reported. This is mainly due to the rareness of the disease and difficulty in appropriately selecting patients for targeted therapy. A trial examining the effect of sunitinib in advance GCT did not show any objective response. Similar results were shown for pazopanib.
In a recent pan-cancer study assessing RNA sequencing data for CD8A and PDL1 expression from multiple TCGA databases, GCT demonstrated very high levels of expression that are seen only with other highly immune recognized cancers such as melanoma. This suggests the potential role of immunotherapy. 73% and 64% of seminomas and non seminomas respectively were found to be PDL1 positive. Furthermore, PD1 and PDL1 were able to predict PFS and OS. There are several ongoing trials for checkpoint blockade in GCT.
Presenter: Aditya Bagrodia, MD, The University of Texas Southwestern Medical Center
Written By: Miki Haifler, MD, M.Sc, Fox Chase Cancer Center
at the 2017 Genitourinary Cancers Symposium - February 16 - 18, 2017 – Orlando, Florida USA