Researchers have found that high-dose chemotherapy and multimodality treatment seemed to improve survival probabilities in men with bone metastases (BM) from germ cell tumors (GMT) at relapse, according to an article published online ahead of print in the Journal of Clinical Oncology.1
In this retrospective study, data from 523 with BM from GCT were obtained by using standardized questionnaires. Clinical features were correlated with overall survival as the primary end point. Men in group A (n=228) had BM present at initial diagnoses and men in group B (n=295) had BM at relapse.
Overall survival at 3 years was superior in group A vs group B (48% vs 27%; P<0.001). Independent adverse prognostic factors in both groups were the presence of liver or bone metastasis; primary mediastinal nonseminoma (group A) and elevations of α-fetoprotein of 100 mg/mL or greaster or of human chorionic gonadotropin of 5,000 U/L or greater (group B) were respective adverse prognostic factors.
Depending on these factors, the 3-year overall survival rate ranged from 0% to 70% in group A and from 6% to 52% in group B.
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Ninety-nine percent of patients in group A received chemotherapy as compared with 54% in group B. In group A, multimodality treatment or high-dose chemotherapy was not associated with statistically improved survival in multivariable analysis, however in group B multimodality treatment was associated with improved survival compared with single-modality therapy (hazard ratio, 0.51; 95% CI: 0.36-0.73; P<.001), along with high-dose conventional dose chemotherapy (hazard ratio, 0.41; 95% CI:0.24 to 0.70; P=.001).
- Feldman DR, Lorch A, Kramar A, et al. Brain metastases in patients with germ cell tumors: prognostic factors and treatment options—an analysis from the global germ cell cancer group. [published online ahead of print October 12, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.62.7000.