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Re-induction chemotherapy regimens in patients with recurrent central nervous system mixed malignant germ cell tumors

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Abstract

Background

The lack of a standard treatment approach has contributed to poor outcomes of patients with recurrent central nervous system (CNS) mixed malignant germ cell tumors (MMGCT). There are no data in the literature supporting optimal re-induction chemotherapy regimens that should be used for patients with recurrent CNS MMGCT.

Methods

We conducted a literature review to explore the response rate of patients with recurrent CNS MMGCT to different re-induction chemotherapy regimens by searching PubMed from 1985 through November 2017. Tumors were classified according to Japanese, European, and North American prognostic group classifications determined at initial presentation.

Results

Forty-two responses to various re-induction chemotherapy regimens reported in 38 patients were included. Two patients were inevaluable and their responses to re-induction chemotherapy were excluded. Thirty-five responses to various re-induction chemotherapy regimens were evaluable in 33 patients following a first relapse. Six (17%) responses were reported as complete or continuous complete responses, seven (20%) partial responses, two (6%) were stable disease, two (6%) were mixed responses, and 18 (51%) were progressive disease. Five of ten patients treated without platinum-based chemotherapy experienced tumor progression. There was a trend towards a higher rate of tumor progression among histological poor prognostic group patients, and among patients relapsing within 24 months of initial diagnosis; however, it was not statistically significant.

Conclusions

The histological prognostic group and time to relapse may affect the response to re-induction chemotherapy. However, further studies with larger sample size are needed to examine these associations and determine the optimal re-induction chemotherapy regimens for patients with recurrent MMGCT.

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Authors and Affiliations

  1. The Division of Hematology, Oncology and Blood and Marrow Transplant, Nationwide Children’s Hospital, The Ohio State University, 700 Children’s Dr, Columbus, OH, 43205, USA

    Mohammad H. Abu Arja, Joseph R. Stanek, Jonathan L. Finlay & Mohamed S. AbdelBaki

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  1. Mohammad H. Abu Arja
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  2. Joseph R. Stanek
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  3. Jonathan L. Finlay
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  4. Mohamed S. AbdelBaki
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Correspondence to Mohamed S. AbdelBaki.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Detailed information of patients included in the literature review (PDF 189 kb)

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Abu Arja, M.H., Stanek, J.R., Finlay, J.L. et al. Re-induction chemotherapy regimens in patients with recurrent central nervous system mixed malignant germ cell tumors. Childs Nerv Syst 34, 2179–2186 (2018). https://doi.org/10.1007/s00381-018-3940-5

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