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Is the blood-brain barrier relevant in metastatic germ cell tumor?
Jose M Azar1, Bryan P Schneider, Lawrence H Einhorn
1Department of Medicine, Division of Hematology and Oncology, Indiana University, Indianapolis, IN, USA. jazar@iupui.edu
Purpose:
Germ cell tumors are uniquely chemosensitive and curable, even with advanced metastatic disease. Central nervous system recurrence can terminate a complete remission in other chemosensitive tumors, such as small cell lung cancer, because of the blood-brain barrier (BBB). We propose to document that the BBB is also relevant in germ cell tumors despite their dramatic chemosensitivity.
Methods And Materials:
We present five cases illustrating the concept of the BBB in patients with metastatic testicular cancer treated with chemotherapy.
Results:
In our large series of patients with metastatic testicular cancer treated with chemotherapy, we identified 5 unique patients. These patients were rendered free of disease only to experience relapse in the brain alone. This included 1 patient who initially had good-risk metastatic disease by means of the International Germ Cell Collaborative Group staging system at the onset of chemotherapy.
Conclusions:
The BBB is relevant in patients with metastatic testicular cancer.
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