Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Use of Salvage Chemotherapy for Patients with Relapsed Testicular Germ Cell Tumor (GCT) in Canada: A National Survey

Version 1 : Received: 29 May 2023 / Approved: 30 May 2023 / Online: 30 May 2023 (04:48:08 CEST)

A peer-reviewed article of this Preprint also exists.

Al-Ezzi, E.M.; Zahralliyali, A.; Hansen, A.R.; Hamilton, R.J.; Crump, M.; Kuruvilla, J.; Wood, L.; Nappi, L.; Kollmannsberger, C.K.; North, S.A.; Winquist, E.; Soulières, D.; Hotte, S.J.; Jiang, D.M. The Use of Salvage Chemotherapy for Patients with Relapsed Testicular Germ Cell Tumor (GCT) in Canada: A National Survey. Curr. Oncol. 2023, 30, 6166-6176. Al-Ezzi, E.M.; Zahralliyali, A.; Hansen, A.R.; Hamilton, R.J.; Crump, M.; Kuruvilla, J.; Wood, L.; Nappi, L.; Kollmannsberger, C.K.; North, S.A.; Winquist, E.; Soulières, D.; Hotte, S.J.; Jiang, D.M. The Use of Salvage Chemotherapy for Patients with Relapsed Testicular Germ Cell Tumor (GCT) in Canada: A National Survey. Curr. Oncol. 2023, 30, 6166-6176.

Abstract

Background: Although metastatic GCT is highly curable with initial cisplatin-based chemotherapy (CT), 20-30% of patients relapse. Salvage CT options include conventional (CDCT) and high dose chemotherapy (HDCT), however definitive comparative data remains lacking. We aimed to characterize the contemporary practice patterns of salvage CT across Canada. Methods: We conducted a 30-question online survey for Canadian medical and hematological oncologists with experience in treating GCT, assessing treatment availability, patient selection, and management strategies used for relapsed GCT patients. Results: Respondents included 30 staff; from 18 cancer centers across provinces. The most common CDCT regimens used were TIP (64%) and VIP (25%). HDCT was available for (70%) in 13 centers. HDCT regimen used included carboplatin and etoposide for 2 cycles (76% in 7 centers), 3 cycles (6% in two centers), and the TICE protocol (11%, in 2 centers). “Bridging” CDCT was used by 65% respondents. Post HDCT treatments considered include surgical resection for residual disease (87.5%), maintenance etoposide (6.3%) and sur-veillance only (6.3%). Conclusions: HDCT is the most commonly used GCT salvage strategy in Canada. Significant differences exist in the treatment availability, selection and delivery of HDCT, highlighting the need for standardization of care for patients with relapsed testicular GCT.

Keywords

relapsed germ cell tumors; salvage chemotherapy; conventional dose chemotherapy; high dose chemotherapy; autologous stem cell transplant

Subject

Medicine and Pharmacology, Oncology and Oncogenics

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