704P - Characteristics and palliative management of patients with cisplatin-refractory germ cell tumours: A Global Germ Cell Cancer Collaborative Group (G3) retrospective registry study

Background

Patients with metastatic germ cell tumours (GCTs) achieve high cure rates with cisplatin-based combination chemotherapy. About 30% of patients relapse, of which about 50% can be cured with salvage chemotherapy. Here, we assessed clinical characteristics and outcomes of GCT patients with multiply relapsed/refractory disease (r/rGCT) treated with palliative-intent chemotherapy.

Methods

Retrospective case collection from 29 international GCT expert centres via the Global Germ Cell Collaborative Group G3. Patients aged ≥18 years with r/rGCT, who had failed all curative-intent platinum-based chemotherapy lines and received further systemic treatment were included. Details on clinical characteristics, administered treatments and outcomes for r/rGCT were collected via case report forms.

Results

In total, 340 patients with r/rGCT were included. Most GCTs were non-seminomatous (88.2%), and of gonadal origin (76.5%). Median age at primary diagnosis was 29 years (range, 14-79). Median number of curative-intent chemotherapy lines was 2 (range, 1-6). Metastatic spread at first r/rGCT occurence most often involved lungs (55%), retroperitoneal lymph nodes (48.5%) and liver (25.6%) and the most common ECOG PS was 0/1 (76.2%). Median number of applied chemotherapy lines for r/rGCT was 2 (range, 1-7) with gemcitabin/oxaliplatin ± paclitaxel (GO(P) as most frequently used first palliative treatment regimen (156/340, 45.9%). After a median follow-up of 8.0 months (range, 0-211) for the whole cohort, the estimated median progression-free survival (PFS) from first palliative systemic therapy was 3.0 months (95% CI, 2.5 - 3.6) with a 6-months PFS rate of 29.4% and the median overall survival (OS) was 9.0 months (95% CI, 8.0–10.0) with a 12-months OS rate of 35%. At last follow-up, 294 patients (86.5%) had died, almost all from disease progression (99.6%), while only 17 patients (5%) were alive with no evidence of disease after a median follow-up of 28 months.

Conclusions

This retrospective analysis of r/rGCTs confirms very unfavourable outcomes from palliative chemotherapy. Novel treatments are needed to improve outcomes for this patient population.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

C. Oing: Financial Interests, Personal, Invited Speaker, Renal Cancer Expert Panel Case Presentation: Ipsen; Financial Interests, Personal, Invited Speaker, Talk on Pain Management in GU Cancer Patients: Medac; Financial Interests, Personal, Invited Speaker, Case Presentation Soft Tissue Sarcoma: Roche; Financial Interests, Personal, Advisory Board, Ad Board on discussing novel educational events for young haematologists: Novartis; Financial Interests, Personal, Invited Speaker, Science Slam with a presentation on young professional support from oncological societies in Germany: AstraZeneca; Financial Interests, Personal, Advisory Board, AdBoard assessing educational needs for oncology professionals regarding G-CSF use: Sandoz; Financial Interests, Personal, Invited Speaker, Presentation on Burnout and Resilience in medical oncology professionals: Asklepios Hamburg; Financial Interests, Personal, Advisory Board, Larotrectinib use in sarcoma: Bayer; Financial Interests, Personal, Advisory Board, Experiences with Cabo/Nivo as first-line treatment for metastatic RCC: Ipsen; Financial Interests, Personal, Advisory Board, Workshop series on improving customer experience: Pfizer; Non-Financial Interests, Other, Clinical Advisory role in early drug discovery with a fellowship position affiliated with Astex Pharmaceuticals, Cambridge, UK: Astex Pharmaceuticals; Non-Financial Interests, Institutional, Product Samples, Cytotoxic Agent for Preclinical Experiments: PharmaMar. A. Tryakin: Financial Interests, Personal, Invited Speaker: Bristol Myers Squibb, MSD, Eli Lilly, Merck, Amgen, Biocad; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb, AstraZeneca, R-pharm, Biocad; Financial Interests, Institutional, Local PI: MSD, BMS; Financial Interests, Personal and Institutional, Steering Committee Member: Eli Lilly. U. De Giorgi: Financial Interests, Personal, Advisory Board: Pfizer, BMS, MSD, PharmaMar, Astellas, Bayer, Ipsen, Novartis, EISAI, Janssen; Financial Interests, Personal, Invited Speaker: Roche, BMS, AstraZeneca, Merck; Financial Interests, Institutional, Research Grant: AstraZeneca, Sanofi, Roche. H. Sagstuen Haugnes: Financial Interests, Institutional, Advisory Board: Merck; Financial Interests, Personal, Speaker, Consultant, Advisor: Janssen-Cilag; Financial Interests, Institutional, Speaker, Consultant, Advisor: Bayer. J.A. Gietema: Financial Interests, Institutional, Research Grant, Research grant paid to the institution UMCG: Roche, Siemens, AbbVie. S.C. Fischer: Financial Interests, Institutional, Invited Speaker: Janssen; Financial Interests, Institutional, Advisory Board: Ipsen; Financial Interests, Institutional, Coordinating PI: MSD, Astellas; Other, Travel support: Bayer. X. Garcia Del Muro: Financial Interests, Personal, Advisory Board: Ipsen, BMS, Pfizer, Roche, Pharmamar, GSK, Merck, Deciphera, MSD; Financial Interests, Personal, Invited Speaker: Lilly, Astellas Pharma, Eisai, Pfizer, Recordati; Financial Interests, Institutional, Research Grant: AZ, Incyte. M. Ottaviano: Financial Interests, Personal, Invited Speaker: Novartis, BMS, AMGEN, Sanofi; Non-Financial Interests, Member: IGG Italian Germ Cell Cancer Group, AIOM Associazione Italiana di Oncologia Medica, ENETS. C. Bokemeyer: Financial Interests, Personal, Advisory Board, advisory boards and speaker: Merck Serono; Financial Interests, Personal, Invited Speaker: Roche Pharma, AOK Germany; Financial Interests, Personal, Advisory Board: Bayer Healthcare, Oncology Drug Consult CRO, Lindis Biotech, BioNTech, Heaxal; Financial Interests, Personal, Advisory Board, Boards attended and lectures given: Sanofi Aventis; Financial Interests, Personal, Advisory Board, advisory board and speaker: AstraZeneca; Financial Interests, Personal, Invited Speaker, organisation for medical education: med update; Financial Interests, Institutional, Local PI, our department is involved in several clincal trials sponsored by industry and cooperative groups where we hold participants roles and local PI roles and PI roles: more than 95 clinical trials; Non-Financial Interests, Advisory Role: DGHO; Non-Financial Interests, Leadership Role: Hamburg Cancer Society, National Network of German Cancer Centers (DKH); Non-Financial Interests, Member of Board of Directors: Northern German Society of Internal Medicine; Non-Financial Interests, Advisory Role, Board of DGHO Advisors: DGHO; Non-Financial Interests, Advisory Role, Board of Directors Oncology Center Certification Committee: German Cancer Society. All other authors have declared no conflicts of interest.