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PD34-07 DOES TERATOMA METASTASIZE? PRESENCE OF TERATOMA IN THE PRIMARY RETROPERITONEAL LYMPH NODE DISSECTION SETTING
THE JOURNAL OF UROLOGYâ
Vol. 195, No. 4S, Supplement, Monday, May 9, 2016
PD34-06 SALVAGE CHEMOTHERAPY WITH PACLITAXEL, IFOSFAMIDE AND NEDAPLATIN (TIN) FOR REFRACTORY OR RELAPSED GERM CELL TUMORS IN PATIENTS WITH IMPAIRED RENAL FUNCTION Takumi Shiraishi*, Terukazu Nakamura, Masakatsu Oishi, Takashi Ueda, Hiroyuki Nakanishi, Yoshio Naya, Fumiya Hongo, Kazumi Kamoi, Koji Okihara, Osamu Ukimura, Kyoto, Japan INTRODUCTION AND OBJECTIVES: Cisplatin is one of the most widely used and highly effective drug for the treatment of various solid tumors including germ cell tumors (GCTs). However, it has dosedependent side effects and among them, nephrotoxicity is the most well-known and clinically important toxicity. Nedaplatin is a secondgeneration platinum complex with reduced nephrotoxicity that exerts its antitumor activity against various cancers. Based on our previous report (Int J Clin Oncol 2009;14:436), nedaplatin exerted the equivalent antitumor effect as cisplatin with less toxicity in patients with relapsed or refractory GCTs. In this study, we investigated the efficacy and safety of a regimen consisting of paclitaxel and ifosfamide plus nedaplatin (TIN) for refractory or relapsed GCTs in patients with impaired renal function. METHODS: Among 68 patients who underwent TIN chemotherapy for refractory or relapsed GCTs, ten patients with study entry criterion of eGFR (estimated glemerular filtration rate) < 60 ml/min/ 1.73m2 were assessed. The combination chemotherapy consisted of paclitaxel (210 mg/m2) on day 1 and ifosfamide (1.2 g/m2) on days 2-6 in combination with nedaplatin (100 mg/m2) on day 2 every 3 weeks. RESULTS: Patients enrolled in this study exhibited eGFR with a median of 49.97 mg/ml/1.73m2 (range 31.7-57.5). Paclitaxel, ifosfamide and nedaplatin therapy was carried out as second-line therapy in 4 patients, third-line in 4 and fourth-line or later in 2. Patients were pretreated with a median of 5.5 cycles of platinum-based chemotherapy (range 3-11 cycles) and administered with a median of 550mg/m2 of cisplatin. Patients received 2-6 cycles of the TIN combination chemotherapy and the overall response rate was 90%. No patient with chemotherapy-induced kidney dysfunction was observed. Furthermore, among the patients undergoing TIN therapy, there was no difference in the frequency of side effects between eGFR ?60 ml/min/1.73 m2 and eGFR <60 ml/min/1.73 m2 groups. CONCLUSIONS: Paclitaxel, ifosfamide and nedaplatin chemotherapy is considered to be one of the effective and safe regimens in GCTs patients with impaired renal function.
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retroperitoneum 20% of the time. A small subset of patients from all three groups had only teratoma in the retroperitoneum (Table 2). CONCLUSIONS: Regardless of the testis histology, it appears that teratoma has the ability to metastasize to the retroperitoneum and should not be considered a benign finding. The biological mechanism is unclear; however, we present a number of cases in which only apparent teratomatous elements metastasize.
Source of Funding: none
Source of Funding: none
PD34-08 PD34-07 DOES TERATOMA METASTASIZE? PRESENCE OF TERATOMA IN THE PRIMARY RETROPERITONEAL LYMPH NODE DISSECTION SETTING
IMMUNE PROFILING OF TESTICULAR GERM CELL TUMORS REVEALS HIGH EXPRESSION OF PD-L1 AND PD-1
Joseph M. Jacob*, Clint Cary, Lawrence H. Einhorn, Richard S. Foster, Indianapolis, IN
Diana Taheri, Maria A Mendoza Rodriguez, Alcides Chaux, Charles Drake, Trinity J Bivalacqua, Alan Meeker, Janis Taube, Nilda Gonzalez-Roibon, William Nelson, Sirinivasan Yegnasubramanian, George Netto, Michael Haffner*, Baltimore, MD
INTRODUCTION AND OBJECTIVES: To determine if teratoma can metastasize from the testis to the retroperitoneum in clinical stage I chemotherapy naive patients. METHODS: The Indiana University testis cancer database was queried to identify clinical stage I patients at presentation who underwent a primary retroperitoneal lymph node dissection (RPLND) between 2000 and 2011. After excluding patients with malignant transformation, pure seminoma, non-germ cell tumors, and second primary tumors, a total of 391 patients were identified. Testis and retroperitoneal histologies were subdivided into 3 groups: mixed with the presence of teratoma, no teratoma, and teratoma only. Statistical analysis was performed using Fisher’s exact test for categorical variables. RESULTS: Patient characteristics are described in Table 1. Patients with no teratoma in the testis had teratoma in the retroperitoneum 4.8% of the time. Patients with teratoma present in the testis mixed with other histologies had teratoma in the retroperitoneum 9.2% of the time. Patients with teratoma only in the testis had teratoma in the
INTRODUCTION AND OBJECTIVES: Objective: Activation of the immunosuppressive PD-1/PD-L1 (programmed death ligand 1) pathway has been shown to be an important immune surveillance evasion mechanism in solid tumors. As demonstrated in recent phase III clinical trials, blockade of PD-1 signaling holds great promise for the treatment of a subset of solid tumors. Testicular germ cell tumors (TGCT) have been long recognized to harbor extensive lymphocytic infiltrates, suggesting a dominant role for immune editing in these lesions. Here we evaluated the tumor specific immune microenvironment in TGCTs to determine a potential utility for immune checkpoint blockade therapies in these tumors. METHODS: Methods: Here we profiled the immune infiltrate in TGCT with particular focus on immune checkpoint and T-regulatory cell function. Using validated immunohistochemical stains for PD1 (antiPD1 antibody “ab52587”), PDL-1 (Cell Signalling, E1L3N, 1:100), FOXP3 (eBioscience, 236A/E7, 1:250) and a double immunostain for CD8 and ki67 (Thermo Scientific, SP16, 1:900 and Invitrogen/Zymed
Vol. 195, No. 4S, Supplement, Monday, May 9, 2016
PD34-06 SALVAGE CHEMOTHERAPY WITH PACLITAXEL, IFOSFAMIDE AND NEDAPLATIN (TIN) FOR REFRACTORY OR RELAPSED GERM CELL TUMORS IN PATIENTS WITH IMPAIRED RENAL FUNCTION Takumi Shiraishi*, Terukazu Nakamura, Masakatsu Oishi, Takashi Ueda, Hiroyuki Nakanishi, Yoshio Naya, Fumiya Hongo, Kazumi Kamoi, Koji Okihara, Osamu Ukimura, Kyoto, Japan INTRODUCTION AND OBJECTIVES: Cisplatin is one of the most widely used and highly effective drug for the treatment of various solid tumors including germ cell tumors (GCTs). However, it has dosedependent side effects and among them, nephrotoxicity is the most well-known and clinically important toxicity. Nedaplatin is a secondgeneration platinum complex with reduced nephrotoxicity that exerts its antitumor activity against various cancers. Based on our previous report (Int J Clin Oncol 2009;14:436), nedaplatin exerted the equivalent antitumor effect as cisplatin with less toxicity in patients with relapsed or refractory GCTs. In this study, we investigated the efficacy and safety of a regimen consisting of paclitaxel and ifosfamide plus nedaplatin (TIN) for refractory or relapsed GCTs in patients with impaired renal function. METHODS: Among 68 patients who underwent TIN chemotherapy for refractory or relapsed GCTs, ten patients with study entry criterion of eGFR (estimated glemerular filtration rate) < 60 ml/min/ 1.73m2 were assessed. The combination chemotherapy consisted of paclitaxel (210 mg/m2) on day 1 and ifosfamide (1.2 g/m2) on days 2-6 in combination with nedaplatin (100 mg/m2) on day 2 every 3 weeks. RESULTS: Patients enrolled in this study exhibited eGFR with a median of 49.97 mg/ml/1.73m2 (range 31.7-57.5). Paclitaxel, ifosfamide and nedaplatin therapy was carried out as second-line therapy in 4 patients, third-line in 4 and fourth-line or later in 2. Patients were pretreated with a median of 5.5 cycles of platinum-based chemotherapy (range 3-11 cycles) and administered with a median of 550mg/m2 of cisplatin. Patients received 2-6 cycles of the TIN combination chemotherapy and the overall response rate was 90%. No patient with chemotherapy-induced kidney dysfunction was observed. Furthermore, among the patients undergoing TIN therapy, there was no difference in the frequency of side effects between eGFR ?60 ml/min/1.73 m2 and eGFR <60 ml/min/1.73 m2 groups. CONCLUSIONS: Paclitaxel, ifosfamide and nedaplatin chemotherapy is considered to be one of the effective and safe regimens in GCTs patients with impaired renal function.
e841
retroperitoneum 20% of the time. A small subset of patients from all three groups had only teratoma in the retroperitoneum (Table 2). CONCLUSIONS: Regardless of the testis histology, it appears that teratoma has the ability to metastasize to the retroperitoneum and should not be considered a benign finding. The biological mechanism is unclear; however, we present a number of cases in which only apparent teratomatous elements metastasize.
Source of Funding: none
Source of Funding: none
PD34-08 PD34-07 DOES TERATOMA METASTASIZE? PRESENCE OF TERATOMA IN THE PRIMARY RETROPERITONEAL LYMPH NODE DISSECTION SETTING
IMMUNE PROFILING OF TESTICULAR GERM CELL TUMORS REVEALS HIGH EXPRESSION OF PD-L1 AND PD-1
Joseph M. Jacob*, Clint Cary, Lawrence H. Einhorn, Richard S. Foster, Indianapolis, IN
Diana Taheri, Maria A Mendoza Rodriguez, Alcides Chaux, Charles Drake, Trinity J Bivalacqua, Alan Meeker, Janis Taube, Nilda Gonzalez-Roibon, William Nelson, Sirinivasan Yegnasubramanian, George Netto, Michael Haffner*, Baltimore, MD
INTRODUCTION AND OBJECTIVES: To determine if teratoma can metastasize from the testis to the retroperitoneum in clinical stage I chemotherapy naive patients. METHODS: The Indiana University testis cancer database was queried to identify clinical stage I patients at presentation who underwent a primary retroperitoneal lymph node dissection (RPLND) between 2000 and 2011. After excluding patients with malignant transformation, pure seminoma, non-germ cell tumors, and second primary tumors, a total of 391 patients were identified. Testis and retroperitoneal histologies were subdivided into 3 groups: mixed with the presence of teratoma, no teratoma, and teratoma only. Statistical analysis was performed using Fisher’s exact test for categorical variables. RESULTS: Patient characteristics are described in Table 1. Patients with no teratoma in the testis had teratoma in the retroperitoneum 4.8% of the time. Patients with teratoma present in the testis mixed with other histologies had teratoma in the retroperitoneum 9.2% of the time. Patients with teratoma only in the testis had teratoma in the
INTRODUCTION AND OBJECTIVES: Objective: Activation of the immunosuppressive PD-1/PD-L1 (programmed death ligand 1) pathway has been shown to be an important immune surveillance evasion mechanism in solid tumors. As demonstrated in recent phase III clinical trials, blockade of PD-1 signaling holds great promise for the treatment of a subset of solid tumors. Testicular germ cell tumors (TGCT) have been long recognized to harbor extensive lymphocytic infiltrates, suggesting a dominant role for immune editing in these lesions. Here we evaluated the tumor specific immune microenvironment in TGCTs to determine a potential utility for immune checkpoint blockade therapies in these tumors. METHODS: Methods: Here we profiled the immune infiltrate in TGCT with particular focus on immune checkpoint and T-regulatory cell function. Using validated immunohistochemical stains for PD1 (antiPD1 antibody “ab52587”), PDL-1 (Cell Signalling, E1L3N, 1:100), FOXP3 (eBioscience, 236A/E7, 1:250) and a double immunostain for CD8 and ki67 (Thermo Scientific, SP16, 1:900 and Invitrogen/Zymed