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ASCO 2021: Late Relapse of Germ Cell Tumors: Detection and Treatment Outcomes

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  • ASCO 2021: Late Relapse of Germ Cell Tumors: Detection and Treatment Outcomes

    When I was diagnosed with a relapse of seminoma 6 years after adjuvant carboplatin I started reading and searching the topic again. I saw a video where Dr Einhorn mentioned that he was seeing platinum in urine of patients 20 years after treatment and that platinum drugs seem implicated in secondary cancers. I wondered if this is why adjuvant carboplatin is less recommended lately. I recently stumbled across this paper and a couple phrases caught my attention.

    ASCO 2021: Late Relapse of Germ Cell Tumors: Detection and Treatment Outcomes

    … patients who previously received chemotherapy prior to late relapse had more advanced disease at the time of diagnosis (stage III, 50% vs 2%).

    …Assessing their primary outcome, the authors demonstrated significantly higher progression-free survival and overall survival for patients with late relapse who had not previously received chemotherapy.

    https://www.urotoday.com/conference-...-outcomes.html
    6-20-2014 - HCG 43 mIU/mL 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type 8-15-2014 - 1x carboplatin 1-15-2021 - recurrent seminoma with distant metastasis, HCG normal 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

  • #2
    Cisplatin has been "detected" for decades in the bodies of those that have received it. Now, the significance of those levels are a bit unknown. I think any decrease use of carboplatin stems from the no-so-convincing data from SWENOTECA https://www.sciencedirect.com/scienc...23753419356923

    The late relapse presentation is kind of a monster of it's own as it behaves a bit differently than the typical TC and those with previous chemo are thought to have harbored some platinum-resistant TC and thus, surgery is preferred. The later relapse after chemo could be due to the surveillance schedules. I think those issues explain some of the outcomes seen in the ASCO abstract.

    Mike
    Oct. 2005 felt lump but waited over 7 months.
    06.15.06 "You have Cancer"
    06.26.06 Left I/O
    06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
    06.30.06 It's Official - Stage I Seminoma
    Surveillance...
    Founded the Testicular Cancer Society
    6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

    For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

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    • #3
      Thank you Mike. I wonder, is it possible that adjuvant platinum could itself contribute to mutation into platinum resistant cancer cells?
      6-20-2014 - HCG 43 mIU/mL 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type 8-15-2014 - 1x carboplatin 1-15-2021 - recurrent seminoma with distant metastasis, HCG normal 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

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      • #4
        “The later relapse after chemo could be due to the surveillance schedules.”

        Do you mean due to CT radiation exposure?
        6-20-2014 - HCG 43 mIU/mL 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type 8-15-2014 - 1x carboplatin 1-15-2021 - recurrent seminoma with distant metastasis, HCG normal 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

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        • #5
          Originally posted by BrendanF View Post
          “The later relapse after chemo could be due to the surveillance schedules.”

          Do you mean due to CT radiation exposure?
          No, what I mean is typically those that undergo chemotherapy with desired response are monitored less frequently than those that do not receive chemotherapy so the interval between check ups is longer and thus, perhaps more chance for the relapse to grow.

          Mike
          Oct. 2005 felt lump but waited over 7 months.
          06.15.06 "You have Cancer"
          06.26.06 Left I/O
          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
          06.30.06 It's Official - Stage I Seminoma
          Surveillance...
          Founded the Testicular Cancer Society
          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

          For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

          Comment


          • #6
            Thank you Mike
            6-20-2014 - HCG 43 mIU/mL 6-27-2014 - pathology: 3.6 x 3 x 2.3 cm seminoma, classic type 8-15-2014 - 1x carboplatin 1-15-2021 - recurrent seminoma with distant metastasis, HCG normal 2-8-2021 started 4xEP 3-29-2021 switched to 2xEC after 2xEP

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