Treatment and Management in Relapsed/Refractory Malignant Somatic Transformation

Objective: To demonstrate treatment responses, survival analysis and treatment-related mortality characteristics of patients with malignant somatic transformation (MST).Materials and Methods: In this retrospective cross-sectional study, patients with relapsed and refractory MST who had previously received multiple-line chemotherapy were evaluated. Clinical features and follow-up data of relapsed/refractory MST patients were recorded from the patients' registration database at the hospital. Age, clinical stage at initial diagnosis, serum tumour marker levels, visceral metastasis status, previous treatment protocols and follow-up times were recorded. This study aims to demonstrate demographic and disease-related characteristics, best response to systemic therapy, and overall survival (OS) results.Results: The study included 14 patients. Mean age at diagnosis was 29.6 years for the whole group. The most-common sarcoma subtype was Ewing sarcoma (44.4% in the sarcoma group). In half the patients, the best response to systemic treatment was determined as a complete response. Median OS for the sarcoma group was 19.72 months [interquartile range (IQR) 29.18 months], and in the adenocarcinoma group, it was determined as 136.24 months (IQR 131.92 months) (p=0.006). The median OS for the whole group was 28.12 months (IQR 99 months). No significant difference in survival was found between synchronous and relapsed cases [median (IQR) 24.09 (91.23) months vs 43.54 (113.51) months, p=0.606].Conclusions: Germ cell tumour patients with MST should be treated according to the somatic component. Poor responses to cisplatin-based chemotherapy have been found in this cohort. Patients with sarcomatous components were found to have significantly shorter OS.