Serum tumor markers and testicular germ cell tumors: a primer for radiologists

Marshall, Colin; Enzerra, Michael; Rahnemai‐Azar, Amir A.; Ramaiya, Nikhil H.

doi:10.1007/s00261-018-1846-z

Cited by 20 publications

(21 citation statements)

References 36 publications

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“…Evaluation of response was determined by RECIST criteria using CT and MRI and also testicular cancer tumor markers (TMs). 33 All patients with or without measurable disease, were evaluated for TMs (AFP and hCG). The baseline serum AFP needed to be >25 and hCG >10.…”

Section: Patient Populationmentioning

confidence: 99%

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

et al. 2020

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Purpose Germ cell tumors (GCTs) are cured with therapy based on cisplatin, although a clinically significant number of patients are refractory and die of progressive disease. Based on preclinical studies indicating that refractory testicular GCTs are hypersensitive to hypomethylating agents (HMAs), we conducted a phase I trial combining the next‐generation HMA guadecitabine (SGI‐110) with cisplatin in recurrent, cisplatin‐resistant GCT patients. Methods Patients with metastatic GCTs were treated for five consecutive days with guadecitabine followed by cisplatin on day 8, for a 28‐day cycle for up to six cycles. The primary endpoint was safety and toxicity including dose‐limiting toxicity (DLT) and maximum tolerated dose (MTD). Results The number of patients enrolled was 14. The majority of patients were heavily pretreated. MTD was determined to be 30 mg/m2 guadecitabine followed by 100 mg/m2 cisplatin. The major DLTs were neutropenia and thrombocytopenia. Three patients had partial responses by RECIST criteria, two of these patients, including one with primary mediastinal disease, completed the study and qualified as complete responses by serum tumor marker criteria with sustained remissions of 5 and 13 months and survival of 16 and 26 months, respectively. The overall response rate was 23%. Three patients also had stable disease indicating a clinical benefit rate of 46%. Conclusions The combination of guadecitabine and cisplatin was tolerable and demonstrated activity in patients with platinum refractory germ cell cancer.

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Section: Patient Populationmentioning

confidence: 99%

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

et al. 2020

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“…Serum LDH is reported to be correlated with tumor burden, growth rate, cellular proliferation, and is commonly higher in patients with advanced disease (16). It was reported that elevated levels of HCG at the time of treatment completion would eventually relapse, while those with normal or lower levels often achieved cure (12,14,17,18) . As for AFP, researchers had found that AFP is elevated in 10-20% CSI seminoma while those with metastatic disease have elevated AFP 40-60% of the time(19).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Testicular Nonseminomatous Germ Cell Tumor from West China: A 10-Year Experience of a Super regional Center

Chen

Wang

Cao

et al. 2019

Preprint

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Obejectives: To evaluate the clinical characteristics and prognostic factors of Nonseminomatous Germ Cell Tumor (NSGCT). Patients and methods: Testicular cancer (TC) survey was conducted by Department of Urology, West China Hospital from 2008 to 2018. Details such as age, tumor size, tumor markers, histopathology, clinical stage, initial treatment, follow up, and clinical outcomes were provided by the database of our center. Tumor stage was classified according to the NCCN criteria(1). Results: Orchiectomy, chemotherapy and radio-therapy were the main treatments for these patients. Clinical stage I, stage II and stage III patients accounted for 74.6% (150), 7.5% (15) and 17.9% (36), respectively. After a median follow up time of 63 months, 4 patients relapsed during observation and 3 of them died. 4 patients died because of advanced malignancies. Among CSI patients, 2 relapsed and 1 died in 3 months after orchiectomy. No recurrence was found in CSII patients. 2 out of 29 stage III cases relapsed after treatment and 3 died of advanced cancer. The 3- and 10- year OS was 95.6% and 88.7%, respectively. For all the patients, the 3- and 10-year PFS was 94.9% and 88.8%. According to our data, we found that the meatastasis and tumor size were risk factors for NSGCTs. Conclusion: The present report showed a good prognosis at non-metastatic stage(CSI). However, the prognosis of advanced disease(CSII and CSIII) is significantly worse than that of early stage. We also found that maximum tumor diameter of >5cm was a potential risk factor for NSGCT.

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“…54 Yolk-sac tumors have elevated AFP levels in 90% of cases, which usually decrease 5 days after orchiectomy. 54 If AFP levels do not decrease, this raises concern for possible residual primary disease or metastases that were not detected on the initial staging evaluation. 54 Testicular embryonal-cell tumors demonstrate elevated AFP and β-hCG; however, in pure embryonal cell tumors these tumor markers are elevated to a lesser extent.…”

Section: Serological Tumor Markersmentioning

confidence: 99%

“…54 If AFP levels do not decrease, this raises concern for possible residual primary disease or metastases that were not detected on the initial staging evaluation. 54 Testicular embryonal-cell tumors demonstrate elevated AFP and β-hCG; however, in pure embryonal cell tumors these tumor markers are elevated to a lesser extent. Levels of these tumor markers are proportional to tumor burden, and elevation is a sign of poor prognosis.…”

Section: Serological Tumor Markersmentioning

confidence: 99%

<p>Multimodality Radiological Pictorial Review of Testicular Carcinoma: From Initial Staging to Restaging</p>

Revels¹,

Wang²,

Gangadhar³

et al. 2020

RRU

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With an overall 5-year survival rate >95%, patients with testicular cancer have a great prognosis. Although initial diagnosis is based on clinical examination, imaging does play a significant role in the diagnosis and prognosis of testicular cancer, which are dependent on tumor burden and staging. Successful treatment requires appropriate disease assessment throughout a patient's treatment: evaluating treatment response, restaging, and monitoring for disease recurrence after treatment completion. Ultrasound is usually the initial screening modality for painless testicular masses, and computedtomography (CT) the most commonly used for staging and restaging. However, with regard to seminomas, positronemission tomography (PET) combined with CT is slowly taking priority. With regard to nonseminomatous germ-cell tumors, PET-CT has not proven to be completely effective, due to a high number of false-negative results. The purpose of this paper is to provide radiologists with a pictorial review of testicular carcinoma from initial staging through posttreatment follow-up.

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Serum tumor markers and testicular germ cell tumors: a primer for radiologists

Cited by 20 publications

References 36 publications

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

A phase 1 study of combined guadecitabine and cisplatin in platinum refractory germ cell cancer

Clinical Characteristics of Testicular Nonseminomatous Germ Cell Tumor from West China: A 10-Year Experience of a Super regional Center

<p>Multimodality Radiological Pictorial Review of Testicular Carcinoma: From Initial Staging to Restaging</p>

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