Among patients with central nervous system-non-germinomatous germ cell tumors (CNS-NGGCT), metastatic relapses occur earlier than local relapses, according to research presented at the 20th International Symposium on Pediatric Neuro-Oncology (ISPNO).

Researchers conducted a pooled analysis of clinical trial data to determine the conditions under which patients with CNS-NGGCT are likely to have a treatment failure.

The analysis included 404 patients from clinical trials in Europe and North America (SIOP-GCT96, SFOP-TGM TC 90/92, COG-ACNS0122, and COG-ACNS1123).

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Treatment failure occurred in 118 patients. This group included 24 patients with progressive disease during treatment, 11 with growing teratoma syndrome (GTS), and 83 with post-treatment relapse. 

Patients with GTS were younger than patients with progression or relapse, with median ages of 9 years, 13.7 years, and 13 years, respectively. 

The median time to the event was 5 months for both GTS and progression, and it was 14 months for relapse. Tumor markers were not elevated in patients with GTS, but markers were elevated in patients with relapse or progression.

Metastatic relapse was more likely than local relapse (58% and 41%, respectively). The median time to relapse was 17 months for local relapse and 11 months for metastatic relapse (P =.0063). 

Metastatic relapse was associated with elevated tumor markers, but it was not associated with focal or whole ventricular radiotherapy.


Fonseca A, Faure-Conter C, Murray M, et al. Pattern of treatment failures in central nervous system non-germinomatous germ cell tumors (CNS-NGGCT): A pooled analysis of clinical trials. Presented at ISPNO 2022; June 12-15, 2022. Abstract GCT-04.