Manejo de los Pacientes con Tumores de Celulas Germinales en Primera Recaida
DOI:
https://doi.org/10.35509/01239015.113Palabras clave:
cancer testicular, tumor de células germinales, no seminomatoso, recaída, tratamientoResumen
Los tumores de células germinales (TCG) son las neoplasias malignas más comunes afectando a hombres jóvenes de 15 a 35 años de edad. La terapia óptima para aquellos pacientes con enfermedad recidivante aún está mal definida. Las opciones incluyen regímenes de segunda línea de quimioterapia a dosis convencionales que combinan cisplatino e ifosfamida, con vinblastina,etoposido o paclitaxel, o alternativamente, quimioterapia de altas dosis con soporte de células madres. En vista de que todavía no hay evidencia concluyente de los ensayos clínicos, las indicaciones para el uso de quimioterapia de altas dosis permanecen poco claras.El tratamiento en la segunda recaída debe individualizarse según el paciente y el tratamiento previo. La resección quirúrgica de masas residuales luego de la quimioterapia es un elemento clave para una terapia exitosa. Actualmente en Venezuela, los pacientes que presentan recaídas deben recibir tratamiento con cualquiera de los regímenes establecidos que se utilizan a dosis convencionales en segunda línea. Si el paciente dispone de recursos, debe recibir tratamiento en centros de oncología con un manejo multidisciplinario que permita el acceso a tratamiento con altas dosis de quimioterapia y a cirujanos oncólogos expertos en en esta área.
Referencias bibliográficas
Adra N, Einhorn LH: Testicular cancer update. Clin Adv Hematol Oncol 15: 386–396;2017
Rashdan S, Einhorn LH. Salvage Therapy for patients with germ Cell Tumors. J Clin Pract 12: 437-443; 2016.
Murphy BR, Breeden ES, Donohue JP, et al: Surgical salvage of chemo refractory germ cell tumors. J Clin Oncol 11:324-9; 1993
Lorch, A., Management of Refractory Germ Cell Cancer. Am Soc Clin Oncol Educ Book, 2018(38): p. 324-329
Donadio AC, Motzer RJ, Bajorin DF. Chemotherapy for teratoma with malignant transformation. J Clin Oncol 12:4285-4291; 2003.
Morris MJ, Bosl GJ. Recognizing abnormal marker results that do not reflect disease in patients with germ cell tumors. The Journal of urology. 2000 Mar 1;163(3):796-801.
Klein EA. Tumor markers in testis cancer. Urol Clin North Am 20:67–73. 1993
Gemá JR, Llanos M,Tabernero JUM et al. False elevation of alpha-fetoprotein associated with liver dysfunction in germ Cell tumors. Cancer 72:2491- 2494;1993.
Bloomer JP, Waldmanm TA, McIntyre KR et al. Alpha-fetoprotein non neoplastic hepatic disorders. JAMA 233:38-41;1975.
Schefer H, Mattman S, Joss RA. Hereditary persistence of Alpha fetoprotein. Case report and review of the literature Ann Oncol 9:667-672;1998.
Zon RT, Nichols C. Einhorn LH management strategies and outcomes of germ cell tumor patients with very high human chorionic gonadotropin levels. J Clin Oncol 16:1294-1297,1998
Beyer J, Kramar A, Mandanas R et al High dose Chemotherapy as salvage treatment in germ cell tumors: a multivariable analysis of prognostic variables J Clin Oncol 14:2638-2645,1996.
Prognostic factors in patients with metastatic germ cell tumors who experience failure with first line chemotherapy cisplatin-based chemotherapy: The International prognostic factors Study Group J Clin Oncol 28:4906-4911;2010.
Kondagunta GV, Bacik J, Donadio A et al. Combination of Paclitaxel, ifosfamide and cisplatin is an effective second line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol 23:6549-6555;2005.
Loehrer PJ Sr, Lauer R, Roth BJ, et al. Salvage therapy in recurrent germ cell cancer: ifosfamide and cisplatin plus either vinblastine or etoposide. Ann Intern Med.109:540-546;1988
Mead GM, Cullen MH, Huddart R, et al. MRC Testicular Tumor Working Party. A phase II trial of TIP (paclitaxel, ifosfamide and cisplatin) given as second-line (post-BEP) salvage chemotherapy for patients with metastatic germ cell cancer: a medical research council trial. Br J Cancer 93:178-184;2005
McKenzie HS, Mead G, Huddart R, White JD, Rustin GJ, Hennig IM, Cozens K, Cross N, Bowers M, Wheater MJ. Salvage chemotherapy with gemcitabine, paclitaxel, ifosfamide, and cisplatin for relapsed germ cell cancer. Clinical genitourinary cancer1;16(6):458-465;2018
Sonpavde G, Hutson T and Roth B. Management of Recurrent Testicular Germ Cell Tumors. The Oncologist 12:51-61;2007.
Einhorn LH, Williams SD, Chamness et al. High dose chemotherapy and Stem cell rescue for metastatic germ cell tumors. N Engl J Med 357:340-348;2007.
Pico J. Rosti G. Kramar A et al, A randomized trial of High dose chemotherapy in the salvage treatment of patients failing first line platinum chemotherapy for advanced germ cell tumors. Ann Oncol:16;1152-1159,2005.
Kondagunta GV, Acik J, Scheinfeld J et al. Paclitaxel plus Ifosfamide followed by high dose carboplatin plus etoposide in previously treated germ cell tumors. J Clin Oncol 25:85-90;2007.
Lorch A, Bascoul-Molleri Caroline, kramar A el al. Conventional Dose Versus high dose Chemotherapy as first Salvage treatment in male patients with germ Cell Tumors: Evidence from a large Data base. J Clin Oncol 29:2178-2184;2011
Adra N, Abonour R, Althouse SK, et al. High-Dose Chemotherapy and Autologous Peripheral-Blood Stem-Cell Transplantation for Relapsed Metastatic Germ Cell Tumors: The Indiana University Experience. J Clin Oncol 35 (10) :1096-1102;2017
Lewin J, Dickinson M, Voskoboynik M, Collins M, Ritchie D, Toner G. High‐dose chemotherapy with autologous stem cell transplantation in relapsed or refractory germ cell tumors: outcomes and prognostic variables in a case series of 17 patients. Internal Medicine Journal 44(8):771-8;2014
Lorch A, Kleinhans A, Kramar A et al. Sequential versus single high dose chemotherapy in patients with relapsed or refractory germ cell tumors: long term results of a prospective randomized trial. J Clin Oncol 30;800-805,2012.
Feldman D, Huddart R, Hall E, el al. Is high dose therapy Superior to conventional Dose therapy as initial Treatment for relapse germ Cell Tumors? The Tiger trial. J Cancer 2: 374-377,2011
McHugh DJ, Feldman DR. Conventional-dose versus high-dose chemotherapy for relapsed germ cell tumors. Advances in urology. 2018;2018.1-7
Gossi F, Sphan M, Zweifel M et al. LETTER TO THE EDITOR. Comparison of three or fewer high doses chemotherapy cycles as salvage treatment in germ cell tumors in first relapse: Bone marrow transplantation 52:334-336;2017
Rustin G.R.S., Newlends ES, Bagwshawe K et al. Successful Management of Metastatic and Primary Germ Cell tumors to the Brain. Cancer 57:2108- 2113;1986
Kolmansberger C, Nichols C, Bokemeyer C. Recent advances in management of patients with platinum-refractory testicular germ cell tumors. Cancer 106:1217-1226; 2006
Porcu P, Bhatia S, Einhorn LH. Results of treatment after relapse from high- dose chemotherapy in germ cell tumors, J Clin Oncol 18:1181-1186;2000
Pectasides D, Pectasides M, Farmakis D, et al. Oxaliplatin and irinotecan plus granulocyte-colony stimulating factor as third-line treatment in relapsed or cisplatin-refractory germ-cell tumor patients: a phase II study. Eur Urol 46:216-221;2004
Pectasides D, Pectasides M, Farmakis D, et al. Gemcitabine and oxaliplatin (GEMOX) in patients with cisplatin-refractory germ cell tumors: a phase II study. Ann Oncol 15;493-497:2004
Theodore C, Flechon A, Fizazi K, et al. A phase II multicenter study of oxaliplatin (Ox) in combination with paclitaxel (Px) in patients (pts) who failed cisplatin (CDDP) based chemotherapy (CT) for germ cell tumors (GCT), Proc Am Soc Clin Oncol 23:389 Abst 4534;2004
Miki T, Mizutani Y, Nonomura N, et al. Irinotecan plus cisplatin has substantial antitumor effect as salvage chemotherapy against germ cell tumors. Cancer 95:1879-1885; 2002
De Giorgi U, Rosti G, Aieta M, Testore F, Burattini L, Fornarini G, Naglieri E, Re GL, Zumaglini F, Marangolo M. Phase II study of oxaliplatin and gemcitabine salvage chemotherapy in patients with cisplatin-refractory non Seminomatous germ cell tumor. Eur Urol.50(5):1032-9;2006
Lorch A, Neubauer A, Hackenthal M, et al. High dose chemotherapy (HDCT) as second salvage treatment in patients with multiple relapsed or refractory germ cell tumors. Annals Oncol 21: 820-825;2010.
Mulherin BP, Brames MJ, Einhorn LH. Long-term survival with paclitaxel and gemcitabine for germ cell tumors after progression following high-dose chemotherapy with tandem transplant. Am J Clin Oncol.38(4):373-6;2015
Kolmansberger C, Beyer J, Liersch R, et al. Combination chemotherapy with gemcitabine plus oxaliplatin in patients with intensively pretreated or refractory germ cell cancer: a study of the German Testicular Cancer Study Group. J Clin Oncol 22:108-114;2004.
Hinton., Catalano P, Einhorn LH et al. Phase II study of paclitaxel plus gemcitabine in refractory germ cell tumors (E9897): A trial of the eastern cooperative Group. J Clin Oncol 20:1859-1863;2002.
Nicolai N, Necchi A, Gianni L et al: long term results of a combination of paclitaxel, cisplatin and gemcitabine for salvage therapy in male germ cell tumors BJU INT 104:340-346;2009.
Bokemeyer C, Oechsle K, Honecker F, Mayer F, Hartmann JT, Waller CF, Böhlke I, Kollmannsberger C. Combination chemotherapy with gemcitabine, oxaliplatin, and paclitaxel in patients with cisplatin-refractory or multiply relapsed germ-cell tumors: a study of the German Testicular Cancer Study Group. Annals Oncol 19(3):448-53;2008
Enihorn L,Brames M,Juliar B et al. Phase II study of Paclitaxel and Gemcitabine salvage Chemotherapy for germ cell tumors after progression following high dose chemotherapy with tandem bone transplant. J Clin Oncol 25(5):513-516;2007
Bedano P, Brames M, Williams s el al. Phase II study of Epirubicin and Cisplatin salvage chemotherapy in patients with Refractory Germ Cell tumors. J Clin Oncol 24:5403-5407;2006.
Miller JC, Einhorn LH. Phase II study of daily oral Etoposide in refractory Germ Cell tumors. Sem Oncol 17:(1 supp 2) 36-39,1990.
Maroto P, Huddart R, García del Muro X, et al, Brief Report: phase II multicenter study of Temozolomide in patients with cisplatin resistant Germ Cell tumors. Oncology 80:219-22,2011.
Jain A, Brames MJ, Vaughn DJ, Einhorn LH. Phase II clinical trial of oxaliplatin and bevacizumab in refractory germ cell tumors. American J of Clin Oncol 1;37(5):450-3;2014.
Oechsle K, Bokemeyer C, Honecker F. Lenalidomide in patients with cisplatin- refractory and multiply relapsed germ cell tumors. Journal of cancer research and clinical oncology. J cancer Res Clin Oncol.136(1):165-167. 2010
Feldman DR, Turkula S, Ginsberg MS, Ishill N, Patil S, Carousso M, Bosl GJ, Motzer RJ. Phase II trial of sunitinib in patients with relapsed or refractory germ cell tumors. Investigational new drugs. Aug 1;28(4):523-8:2010
Everolimus in multiply relapsed and cisplatin refractory Germ Cell tumors: results of an open label multicenter trial (RADIT) of the German Testicular cancer study group. J cancer Res Clin Oncol.145 (3);717-723:2019.
Adra N, Einhorn LH, Althouse SK et al. phase II trial of Pembrolizumab in platinum refractory germ cell tumors: a Hoosier Cancer Research Network Study GU-206. Annals Oncol 29:209-214;2018.
Albany C, Einhorn L, Garbo L, Boyd T, Josephson N, Feldman DR. Treatment of CD30‐Expressing Germ Cell Tumors and Sex Cord Stromal Tumors with Brentuximab Vedotin: Identification and Report of Seven Cases. The oncologist 23(3):316-23;2018.
Loeher PJ, Gonin R, Nichols CR, Weathers T, Einhorn L. Vinblastine plus Ifosfamide plus Cisplatin as Initial Salvage Therapy in recurrent Germ Cell Tumors. J Clin Oncol 16;2500-2504:1998.
Lafin J.T., Bagrodia A., Woldu S and Amatruda J.F. New insights into Germ
Cell Tumor Genomics. Andrology 7;507-515:2019.
Bagrodia A, Lee BH, Lee W, Cha EK, Sfakianos JP, Iyer G, Pietzak E, Gao SP, Zabor EC, Ostrovnaya I, Kaffenberger SD. Genetic determinants of cisplatin resistance in Advanced germ Cell tumors. J Clin Oncol 20;34(33) 4000-4007:2016.
Cómo citar
Descargas
Descargas
Publicado
Número
Sección
Licencia
Todos los derechos reservados.
