In an international collaboration to describe effective treatment strategies for intracranial germ cell tumors, Dr. Mark Souweidane and two dozen investigators from Europe and North America have published a new consensus statement to guide decision making. The paper, “Intracranial germ cell tumors in Adolescents and Young Adults: European and North American consensus review, current management and future development,” was published in the November 1, 2021, issue of the journal Neuro-oncology.
Intracranial germ cell tumors primarily affect adolescents and young adults, with the incidence much higher in Asian countries. In the United States and Europe, patients with germ cell tumors are likely to be treated by oncologists rather than neurosurgeons; the goal of the consensus review was to describe the effective strategies used in the West, which have resulted in survival rates of over 90 percent without the use of aggressive surgical intervention.
The new consensus statement, currently under review by the Society for Neuro-Oncology (SNO), European Association for Neuro-Oncology (EANO,) and EUropean reference network for Rare Adult solid CANcers (Euracan), describes the successful strategy of treatment reduction to minimize long-term side effects. The standard Western treatment is a combination of chemotherapy and radiotherapy, based on the results of blood tests and evaluation of cerebrospinal fluid. These tests allow clinicians to identify which of five germ cell tumor subtypes is present and tailor the most promising protocol based on that type. Surgery plays a very limited role, as it can be avoided except in the rare cases when a biopsy or debulking is recommended.
Looking to the future, the collaborators stress the need for more clinical trials, more access to tissue samples for bench research, and a better understanding of the markers and mutations that characterize intracranial germ cell tumors. These tumors are being studied now at Weill Cornell Medicine at the Children's Brain Tumor Project, which Dr. Souweidane co-directs.
See the abstract of the consensus review: Intracranial germ cell tumors in Adolescents and Young Adults: European and North American consensus review, current management and future development