861P - Persistance of CD30 expression in embryonal carcinoma (EC) cells: a retrospective study in multi-relapsed or chemotherapy (CT) refractory germ-cell...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Germ Cell Tumours
Translational Research
Presenter Patrizia Giannatempo
Authors P. Giannatempo1, A. Necchi2, M. Colecchia3, B. Paolini3, N. Nicolai4, D. Raggi2, M. Catanzaro4, R. Salvioni4, D. Biasoni4, A.M. Gianni5
  • 1Dept. Genitourinary, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - milan/IT
  • 2Medical Oncology/urology Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 3Pathology, IRCCS Istituto Nazionale dei Tumori Milano, 20133 - Milan/IT
  • 4Urology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - milan/IT
  • 5Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - milan/IT

Abstract

Background

Despite the high rate of long-term surviving patients (pts) with advanced GCT, a small but invariable proportion of them fail to be cured with conventional or high-dose CT (HDCT) in the salvage setting, followed by surgery. New drugable targets should be set. CD30 is invariably expressed by untreated EC. We aimed at evaluating the persistence of CD30-positivity after CT, either in 1st-line or in the salvage setting.

Methods

We retrieved paraffin-embedded tumor samples and clinical data of all Institutional pts who had persistence of non-teratoma viable cells after ≥ 1 platinum-based CT for advanced disease. An exclusive or prevalent EC component was required and assessed by morphology and Oct-3/4 staining. The entire set was re-assessed for CD30 staining by 2 blinded referral pathologists. CD30-positivity was defined as a >80% membranous staining with a diffuse moderate-to-strong intensity. Clinical data included histology of tumor primary, GCT primitivity, treatment setting and type of surgery.

Results

In the time-frame 12/1990-04/2012, a total of 245 cases with pure EC or mixed GCT residuals were treated at our Institute. Among them, 49 (EC: 16; mixed GCT: 33) had complete data and were suitable tissue for review and re-assessment. 41 pts had retroperitoneal or mediastinal nodes, 18 lung metastases, 3 had either liver, bone or brain mets. 33/49 cases (67%) preserved CD30 positivity. 18/33 (55%) pts had residual disease after 1st-line CT, 15 (45%) after multiple regimens (median 3, range 2–5). 2 pts (6%) had undergone HDCT and 4 (12%) were late relapses. 31 pts (94%) had gonadal primary GCT, 1 had a retroperitoneal and another a mediastinal primary. After a median follow-up of 35 mos (1-249), 16/33 (48%) of CD30+ its are alive compared to 9/16 (56%) of CD30- cases, with a HR (95%,CI) of 1.93 (0.85–4.37).

Conclusions

Our results on selected relapsed pts suggest that EC samples retained CD30 expression even in the far salvage setting, thus confirming to be a reliable target for treatment. This may be representative of a significantly larger patient series. A trend towards a poorer prognosis and shorter survival characterized CD30+ cases.

Disclosure

All authors have declared no conflicts of interest.