Researchers from the University of Indiana have reported that autologous stem cell transplantation can salvage 46% of patients with male choriocarcinoma who have failed initial cisplatin-based chemotherapy. The details of this report were published in the August, 2007 issue of Bone Marrow Transplantation.

Pure choriocarcinoma is a rare tumor comprising less than 2% of all germ cell tumors in men. More frequently, elements of chroriocarcinoma are present with other germ cell histologies such as embrynal type. Pure choriocarcinoma is characterized by high levels of human chorionic gonadotropin (HCG) and hematogenous spread. In some cases, there is no apparent testicular tumor. Pure choriocarcinoma is treated initially with cisplatin-based chemotherapy. Because of the rarity of this tumor, it is difficult to get accurate figures for initial cure rates but they are generally accepted as being lower than for other types of germ cell tumors.

Researchers from theUniversity of Indiana have reported that tandem autologous stem cell transplantation results in a 70% four year disease-free survival rate for 184 patients with metastatic testicular cancer failing first-line therapy (see related news). The current report presents the outcome of 13 patients among these 184 who had pure choriocarcinoma. These 13 patients had pure choriocarcinoma or choriocarcinoma without a testicular tumor being obvious. All had high levels of HCG. All patients received one or two courses of high dose carboplatin and etoposide followed by autologous stem cell infusion. Six patients (46%) are alive and disease-free with a median follow-up of 37 months. One additional patient is a long-term survivor following surgery and third-line chemotherapy.

Comments: These results suggest that patients with pure choriocarcinoma should be considered for high-dose therapy as initial therapy. The optimal strategy could be induction therapy following by consolidation with autologous transplantation.

Reference:  Papiani G, Einhorn LH. Salvage chemotherapy with high-dose carboplatin plus etoposide and autologous blood stem cell transplant in male pure choriocarcinoma: a retrospective analysis of 13 cases. Bone Marrow Transplantation. 2007; 40:235-237.

Related News: Recurrent Testicular Cancer Potentially Curable with High-dose Therapy and Stem Cell Transplant (7/27/2007)