pawisv

Property	Value
?:abstract	INTRODUCTION: Patients with localised CNS-germinoma have excellent survival. More recently, intensive inpatient chemotherapy (carboPEI=carboplatin/etoposide/ifosfamide in Europe) has been effectively employed to reduce radiotherapy fields and/or dose. Current research priorities focus on reducing treatment burden and long-term sequelae. Of note, outpatient-based single-agent carboplatin chemotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology) [Alifrangis,EJC,2020]. Recently, successful vinblastine monotherapy was reported in localised CNS-germinoma [Murray,Neurooncol-Adv,2020]. METHODS: Due to the COVID-19 pandemic, adapted UK guidelines for germ-cell-tumour management were distributed, including potential non-standard treatment options that would reduce hospital visits/admissions. A 30-year-old patient presented with a 32mmx30mmx35mm diameter solid+multi-cystic localised pineal CNS lesion, consistent radiologically with a germ-cell-tumour with prominent teratoma component. Investigation revealed negative AFP/HCG markers and biopsy-proven pure germinoma. After appropriate consent, the patient commenced 12-week induction with weekly vinblastine monotherapy (low-grade-glioma dosing [Lassaletta,JCO,2016]), with wk6&12 MRI re-assessment prior to definitive radiotherapy. RESULTS: Vinblastine was well-tolerated. After initial 4mg/m2 test-dosing (wk1), standard 6mg/m2 was delivered for wk2, but resulted in asymptomatic neutropenia (nadir 0.3x10^9/l) and missed dosing at wk3. Subsequent doses were 4mg/m2, with no further neutropenia. As expected, MRI showed moderate 40% tumour volume reduction by wk12. Surgical resection of the residual presumed teratoma component was undertaken prior to radiotherapy. CONCLUSION: Patients with CNS-germinoma have excellent outcomes and reduction of treatment-effects remains a priority. The exquisite chemosensitivity of germinoma, excellent results from monotherapy for metastatic testicular disease, and early promise of vinblastine monotherapy lend itself to further exploration for CNS-germinoma.
is ?:annotates of	<https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0001483> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0027627> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0039538> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0205851> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0206660> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0442872> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C0543419> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C1997217> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C4040134> <https://research.tib.eu/covid-19/entity/72pawisv_hasAnnotation_C4321295>
?:creator	<https://research.tib.eu/covid-19/entity/Moleron%2C_Rafael%3B_Stoneham%2C_Sara%3B_Ajithkumar%2C_Thankamma%3B_Cross%2C_Justin%3B_Nicholson%2C_James%3B_Murray%2C_Matthew>
?:doi	10.1093/neuonc/noaa222.032
?:doi	<https://research.tib.eu/covid-19/entity/10.1093/neuonc/noaa222.032>
?:externalLink	<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7715855/>
?:journal	Neuro_Oncol
?:license	cc-by-nc
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7715855>
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
is ?:relation_isRelatedTo_publication of	<https://research.tib.eu/covid-19/entity/72pawisv_HAS_C0206660_COEXISTS_WITH_C5203670>
?:source	PMC
?:title	COVD-01. VINBLASTINE MONOTHERAPY INDUCTION FOR LOCALISED CNS GERMINOMA DURING THE COVID-19 PANDEMIC
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-12-04

Property

Value

?:abstract

INTRODUCTION: Patients with localised CNS-germinoma have excellent survival. More recently, intensive inpatient chemotherapy (carboPEI=carboplatin/etoposide/ifosfamide in Europe) has been effectively employed to reduce radiotherapy fields and/or dose. Current research priorities focus on reducing treatment burden and long-term sequelae. Of note, outpatient-based single-agent carboplatin chemotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology) [Alifrangis,EJC,2020]. Recently, successful vinblastine monotherapy was reported in localised CNS-germinoma [Murray,Neurooncol-Adv,2020]. METHODS: Due to the COVID-19 pandemic, adapted UK guidelines for germ-cell-tumour management were distributed, including potential non-standard treatment options that would reduce hospital visits/admissions. A 30-year-old patient presented with a 32mmx30mmx35mm diameter solid+multi-cystic localised pineal CNS lesion, consistent radiologically with a germ-cell-tumour with prominent teratoma component. Investigation revealed negative AFP/HCG markers and biopsy-proven pure germinoma. After appropriate consent, the patient commenced 12-week induction with weekly vinblastine monotherapy (low-grade-glioma dosing [Lassaletta,JCO,2016]), with wk6&12 MRI re-assessment prior to definitive radiotherapy. RESULTS: Vinblastine was well-tolerated. After initial 4mg/m2 test-dosing (wk1), standard 6mg/m2 was delivered for wk2, but resulted in asymptomatic neutropenia (nadir 0.3x10^9/l) and missed dosing at wk3. Subsequent doses were 4mg/m2, with no further neutropenia. As expected, MRI showed moderate 40% tumour volume reduction by wk12. Surgical resection of the residual presumed teratoma component was undertaken prior to radiotherapy. CONCLUSION: Patients with CNS-germinoma have excellent outcomes and reduction of treatment-effects remains a priority. The exquisite chemosensitivity of germinoma, excellent results from monotherapy for metastatic testicular disease, and early promise of vinblastine monotherapy lend itself to further exploration for CNS-germinoma.

is ?:annotates of