914P - Do patients (pts) with advanced nonseminomatous germ cell tumors (aNSGCT) and unfavorable time to normalization (TTN) of tumor markers benefit wit...

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Germ Cell Tumours
Genitourinary Cancers
Presenter Alexey Tryakin
Citation Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371
Authors A. Tryakin1, M. Fedyanin1, J. Sergeev2, A. Bulanov1, B. Akhmedov3, T. Zakharova4, V. Matveev5, I. Fainstein2, A. Garin1, S. Tjulandin1
  • 1Clinical Pharmacology And Chemotherapy, Russian Oncology Research Center named after Blokhin N.N., 115478 - Moscow/RU
  • 2Radiosurgery, Russian Oncology Research Center named after Blokhin N.N., 115478 - Moscow/RU
  • 3Thoracic Surgery, Russian Oncology Research Center named after Blokhin N.N., 115478 - Moscow/RU
  • 4Pathology, Russian Oncology Research Center named after Blokhin N.N., 115478 - Moscow/RU
  • 5Urology, Russian Oncology Research Center named after Blokhin N.N., 115478 - Moscow/RU

Abstract

Background

Three-four cycles of BEP are commonly recognized as a standard 1-st line ChT in aNSGCT. However, there were no trials studying optimal cycles numbers in this setting, especially in case of unfavorable TTN of tumor markers. We performed retrospective single center analysis to evaluate if pts with unfavorable TTN of tumor markers may benefit with prolongation of induction ChT.

Methods

Inclusion criteria were as follows: (1) ChT-naïve aNSGCT pts treated with etoposide- and cisplatin-based chemotherapy; (2) AFP and hCG levels available at days 0 and 18-22 of cycle 1 to calculate TTN (Fizazi K., JCO 2004). Pts who received less than “standard” number of cycles (3xBEP or 4xEP for IGCCCG good risk, 4xBEP for intermediate and poor risk) for any reason were excluded from the analysis. Cox` regression multivariate analysis was also performed. TTN was calculated by K.Fizazi’s methodic (JCO 2004).

Results

From 1987 to 2011 952 pts with aNSGCT received 1-st line ChT. 584 pts matched the inclusion criteria. Unfavorable TTN had 24 (11%), 61 (41%) and 122 (84%) of pts with good, intermediate and poor IGCCCG risk, respectively. More than standard number of cycles received 199 pts. Prolongation of ChT did not result in significant improvement of OS in any IGCCCG prognostic groups irrespectively of TTN (Table).Table:

914P

IGCCCG risk groupTTN/# of cyclesN pts5-y OS, %p (HR, 95%CI)
Goodfavorable/standard17692%0,44
favorable/>standard4298%(HR 0,63, 0,23-1,89)
unfavorable/standard1593%0,65
unfavorable/> standard978%(HR 1,48, 0.24-10.48)
Intermediatefavorable/standard12788%0,14
favorable/>standard2080%(HR 2,1, 0,73-9,38)
unfavorable/standard3281%0,66
unfavorable/> standard2986%(HR 0,78, 0.25-2.41)
Poorfavorable/standard1291%0,17
favorable/>standard10100%(HR 0,14, 0.01-2.27)
unfavorable/standard2365%0,55
unfavorable/> standard8972%(HR 0,79, 0.33-1.79)

Conclusions

Prolongation of 1-st line ChT beyond standard number of cycles does not improve outcome of pts with unfavorable TTN of tumor markers.

Clinical trial identification

Legal entity responsible for the study

Alexey Tryakin

Funding

None

Disclosure

All authors have declared no conflicts of interest.