Konference: 2008 33st Congress ESMO - účast ČR
Kategorie: Genitourinární nádory
Téma: Genitourinary tumors
Číslo abstraktu: 639P
Methods: Serum tumor markers were obtained before chemotherapy and after two cycles of treatment from 235 patients accrued in the IT94 trial (114 and 121 in the 4VeIP and the 3 VeIP+PEC arms, respectively). The decline of serum alfa-fetoprotein (AFP) and human chorionic gonadotropin (hCG) was assessed and classified into the ‘‘favorable marker decline’’ and the ‘‘unfavorable marker decline’’ groups classified using a mathematical model.
Results: Serum AFP decline was significantly associated with PFS (HR=2.17; p=0.0003)while serum hCG decline did not affect the outcome. Among patients with a favorable AFP decline, those who were treated in the high-dose chemotherapy arm had a better PFS (2-year PFS rate: 56% versus 36%; HR=0.58; p=0.007), and a trend for a better OS (2-year OS rate: 70% versus 56%; HR=0.69; p=0.11) as compared to patients who were in the conventional chemotherapy arm. In contrast, among patients with an unfavorable AFP decline, those who received conventional chemotherapy had a better PFS (2-year PFS: 56% versus 36%; HR=2.22; p=0.025) and a non-significant trend for a better OS (2-year OS: 54% versus 21%; HR=2.43; p=0.34), as compared to those who received high-dose chemotherapy.
Conclusion: These data suggest that AFP decline during the first 6 weeks of salvage chemotherapy predicts PFS in patients with disseminated GCT. High-dose chemotherapy may be beneficial only to selected patients with a favorable AFP decline. This would require a prospective validation.
Datum přednesení příspěvku: 12. 9. 2008