Table 2.
Summary of the key questions and answers.
| Questions | Responses | n | Total Response | % |
|---|---|---|---|---|
| 1. Which of the following salvage chemotherapy treatments do you oversee at your center? | Use of CDCT only | 14 | 30 | 46.6 |
| Use both CDCT and HDCT | 12 | 40 | ||
| Use of HDCT & ASCT only | 4 | 13.3 | ||
| 2. Number of patients receiving salvage chemotherapy (CDCT, or HDCT) for relapsed GCT at your center | <1 cases/year | 5 | 30 | 16.6 |
| 1 case/year | 7 | 23.3 | ||
| 1–5 cases/year | 12 | 40 | ||
| 6–10 cases/year | 6 | 20 | ||
| 3. Percentage of salvage HDCT + ASCT given in the following treatment settings (% reflect averages of responses for each) (range) | First-line setting | 69% (0–100) | ||
| Second-line salvage setting | 33% (0–100) | |||
| Third-line salvage setting or beyond | 4% (0–20) | |||
| 4. If salvage HDCT + ASCT is not available at your center, when do you typically refer patients with relapsed germ cell tumors for salvage HDCT + ASCT? | Upon the first relapse after first line of cisplatin | 6 | 8 | 75 |
| Upon further relapse after salvage CDCT | 1 | 12.5 | ||
| I do not usually refer a patient | 1 | 12.5 | ||
| 5. Is “bridging” CDCT given while waiting for HDCT + ASCT? | No. HDCT can be organized in 3 weeks | 5 | 20 | 25 |
| No. HDCT takes 3–6 weeks to organize, but no “bridging” CDCT is used | 2 | 10 | ||
| Yes | 13 | 65 | ||
| 6. Is disease response (biochemical and/or radiographic) to” bridging” CDCT required to proceed with salvage HDCT + ASCT at your center? | Always. Patients receive HDCT + ASCT only if evidence of disease response. |
1 | 13 | 7.7 |
| Never. Patients proceed to HDCT + ASCT regardless | 9 | 69.2 | ||
| Case by case discussion | 3 | 23.1 | ||
| 7. When do you initiate apheresis/collection after completion of “bridging” CDCT? | Within 4 weeks | 9 | 13 | 69.2 |
| Within 4–6 weeks | 1 | 6.9 | ||
| Within 6–8 weeks | 1 | 6.9 | ||
| I do not know | 2 | 15.3 | ||
| 8. Minimum number of collected CD34 cells required for salvage HDCT + ASCT to proceed | CD34+ cell count 2–3 × 106/kg | 6 | 18 | 33.3 |
| CD34+ cell count 3.1–4 × 106/kg | 1 | 5.6 | ||
| CD34+ cell count 4.1–6 × 106/kg | 0 | 0 | ||
| CD34+ cell count >6 × 106/kg | 1 | 5.6 | ||
| I do not know | 10 | 55.5 | ||
| 9. Initiation ASCT after peripheral stem cells collection | Within 2 weeks | 6 | 18 | 33.3 |
| Within 2–4 weeks | 6 | 33.3 | ||
| Within 4–6 weeks | 1 | 5.5 | ||
| I do not know | 5 | 27.7 | ||
| 10. Salvage HDCT + ASCT required planned admission to hospital | Yes | 15 | 18 | 83.3 |
| No | 3 | 16.7 | ||
| 11. Do the tumor markers and CT results post-first-cycle of HDCT + ASCT affect your decision to proceed with subsequent cycle of HDCT? | Yes. If disease progression, subsequent cycle of HDCT is abandoned. | 6 | 16 | 37.5 |
| No. Patient proceeds with subsequent cycle of HDCT regardless. | 6 | 37.5 | ||
| Case-by-case | 4 | 25 | ||
| 12. Surveillance investigations after completion of salvage HDCT + ASCT within the first year. | Tumor markers every 3 months | 16 | 24 | 50 |
| Imaging every 4 months | 16 | 50 |
Abbreviations: CDCT, conventional-dose chemotherapy; HDCT, high-dose chemotherapy; ASCT, autologous stem cell transplant.