Literature DB >> 23624209

Persistent CD30 expression by embryonal carcinoma in the treatment time course: prognostic significance of a worthwhile target for personalized treatment.

Patrizia Giannatempo1, Biagio Paolini, Rosalba Miceli, Daniele Raggi, Nicola Nicolai, Elena Farè, Mario Catanzaro, Davide Biasoni, Tullio Torelli, Silvia Stagni, Luigi Piva, Luigi Mariani, Roberto Salvioni, Maurizio Colecchia, Alessandro Massimo Gianni, Andrea Necchi.   

Abstract

PURPOSE: CD30 is expressed by untreated embryonal carcinoma, supporting the rationale for a targeted approach. However, the reported chemotherapy induced switching off of CD30 noted on immunohistochemistry may affect its therapeutic potential for disease relapse. We evaluated persistent CD30 expression and its prognostic meaning in cases of post-chemotherapy residual disease.
MATERIALS AND METHODS: Paraffin blocks of surgical samples that yielded nonteratomatous viable cells after 1 or more cisplatin based chemotherapy treatments were retrieved and reassessed by 2 pathologists blinded to the study purpose. Multivariable analysis was done for prespecified factors.
RESULTS: A total of 49 cases of pure embryonal carcinoma or mixed germ cell tumor from August 1991 to August 2012 had full clinical data and suitable tissue available for analysis. Of the 35 cases (71.4%, 95% CI 56.7-83.4) with preserved CD30 positivity 14 (40.0%) showed residual disease after a median of 1 regimen (IQR 1-2). Five-year overall survival in CD30 positive and negative cases was 37.0% (95% CI 22.1-61.8) and 50.1% (95% CI 27.9-90.0, p=0.078), while after first line treatment it was 23.2% (95% CI 8.6-62.5) and 47.6% (95% CI 18.8-100, p=0.025), respectively. On multivariable analysis CD30 positivity was a significant prognostic factor for progression-free survival (HR 2.32, 95% CI 1.04-5.19) and overall survival (HR 2.77, 95% CI 1.05-7.29).
CONCLUSIONS: CD30 was retained even after an intensive pretreatment load, confirming that it is a reliable treatment target. Its expression was associated with a significantly poorer prognosis in multiple relapse/chemoresistant cases and it was an independent prognostic factor for survival.
Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Entities:  

Keywords:  AFP; CD30; ECA; GCT; HCG; MVA; OS; PFS; antigens; carcinoma; drug resistance; embryonal; embryonal carcinoma; germ cell tumor; human chorionic gonadotropin; multivariable analysis; overall survival; progression-free survival; recurrence; testis; α-fetoprotein

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Year:  2013        PMID: 23624209     DOI: 10.1016/j.juro.2013.04.057

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  9 in total

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  9 in total

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