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High Dose Chemotherapy With Autologous Stem Cell Transplant for Patients With Advanced Germ Cell Tumors: Real-World Evidence From a Tertiary Cancer Center in Brazil.
Polho, Gabriel Berlingieri; Cunha, Mateus Trinconi; Coelho, Maiana Hamdan Melo; Almeida-Silva, Jamile; Hidalgo Filho, Cassio Murilo; Xavier, Erick Menezes; Crusoe, Nathalia de Souza; Atanazio, Marcelo Junqueira; de Vasconcellos, Vitor Fiorin; Horita, Vivian Naomi; Freitas, Guilherme Fialho; Muniz, David Queiroz; Rocha, Vanderson; Mota, Jose Mauricio.
Afiliação
  • Polho GB; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Cunha MT; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Coelho MHM; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Unit of Cell Therapy of Hematology/Cell therapy Department, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil.
  • Almeida-Silva J; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Hidalgo Filho CM; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Xavier EM; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Unit of Cell Therapy of Hematology/Cell therapy Department, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil.
  • Crusoe NS; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Atanazio MJ; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Unit of Cell Therapy of Hematology/Cell therapy Department, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil.
  • de Vasconcellos VF; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Hospital Universitario Cassiano Antonio de Moraes, Universidade Federal do Espirito Santo, Espírito Santo, Brazi
  • Horita VN; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Freitas GF; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Muniz DQ; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
  • Rocha V; Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31), Unit of Cell Therapy of Hematology/Cell therapy Department, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo (USP), Sao Paulo, SP, Brazil; Instituto DOr de Pesquisa e Ensino, Espírito
  • Mota JM; Genitourinary Medical Oncology Service, Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil; Instituto DOr de Pesquisa e Ensino, Espírito Santo, Brazil. Electronic address: jose.mota@hc.fm.usp.br.
Clin Genitourin Cancer ; 22(3): 102083, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38658209
ABSTRACT

BACKGROUND:

High-dose chemotherapy followed by stem cell transplant (HDCT) is potentially curative for patients with refractory germ cell tumors (rGCT). There is scarce real-world data supporting its implementation in low- and middle-income countries. We described the experience of our tertiary cancer center in Sao Paulo, Brazil.

METHODS:

We identified male patients ≥18 years-old with rGCT referred to HDCT after board discussion. Clinical data, including delays in HDCT protocol, were extracted from medical records, and survival outcomes were estimated using the Kaplan-Meier method. The log-rank test and Cox proportional hazard were used to determine effects on overall survival (OS).

RESULTS:

From January 2013 to January 2023, 34 patients were referred and considered eligible to receive 2 cycles of HDCT. Most patients had primary testicular tumors (82%), nonseminomatous histology (88%), and poor International Germ Cell Collaborative Group (IGCCCG) (79%). Twenty-three patients received HDCT (1 cycle, n = 8; 2 cycles, n = 15). Main reasons for not receiving any HDCT were death due to progressive disease (n = 1), performance deterioration (n = 7), and failure of stem cell mobilization (n = 3). OS at 2 years was 36.7% for the eligible population, 56.1% for patients who underwent at least 1 HDCT, and 77.1% for those who had ≥2 cycles. The 2-year OS rate for patients not given HDCT was 0%. All patients had delays in protocol, and poor-risk patients had longer intervals from referral to protocol initiation (0.7 vs. 1.8 month, P < .01).

CONCLUSION:

Outcomes of patients who received ≥1 HDCT were encouraging; however, only 15 from 34 eligible patients were able to receive the planned 2 cycles of HDCT. Further strategies to minimize treatment delays in low- and middle-income countries are needed.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Neoplasias Embrionárias de Células Germinativas / Centros de Atenção Terciária Limite: Adolescent / Adult / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Clin Genitourin Cancer Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Neoplasias Embrionárias de Células Germinativas / Centros de Atenção Terciária Limite: Adolescent / Adult / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Clin Genitourin Cancer Assunto da revista: NEOPLASIAS / UROLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos