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Germ cell tumors are chemosensitive tumors, and patients with metastatic germ cell tumors can be cured even in the metastatic setting. There are limited treatment options for the patients who have refractory or recurrent disease after high dose chemotherapy (HDCT) with autologous stem cell transplantation. We aimed to show real-life data on health outcomes in adult patients with recurrent or refractory germ cell tumor who received the gemcitabine, oxaliplatin, and paclitaxel (GemPOx) combination regimen. We analyzed the data of 33 patients receiving GemPOx regimen after HDCT in our department between January 2016 and January 2020. Primary objectives were overall response rate (ORR), overall survival (OS), and progression-free survival (PFS). The mean age of the study group was 31.5 ± 8.2 years. Of the 33 patients, 27 (81.8%) were men. The median OS and PFS were 16 months (95% CI: 7.33-24.7) and 10 months (95% CI: 5.1-14.9), respectively. The one-year OS and PFS were 65.7% and 40%, respectively. ORR was 42.4%. Toxicity was managable. Our study demonstrates acceptable safety and efficacy of GemPOx regimen for relapsed refractory patients with germ cell tumors. GemPOx remains one of the best determined systemic treatment options for progressive germ cell tumors patients after HDCT. [ABSTRACT FROM AUTHOR]

Ovarian germ cell tumors (GCT) are derived from primordial germ cells of the ovary. Choriocarcinomas are more commonly of placental than ovarian origin in a woman. Vaginal choriocarcinoma is seen very rare in the literature. If the germ cell tumors are relapsed or refractory to the salvage chemotherapy, autologous hematopoietic stem cell transplantation (AHSCT) can be used for the treatment. Our aim is to present a rare vaginal choriocarcinoma patient who underwent AHSCT due to the relapsed disease. A 46-year-old woman who had two vaginal deliveries 18 years ago, presented with a vaginal mass. The diagnosis was made as choriocarcinoma after abscess drainage. Due to the elevated levels of β-HCG, she had undergone chemotherapy. After the four lines chemotherapy serum tumor markers remained high. Because of that reason, AHSCT was performed and after the transplantation, the β-HCG level has decreased. The patient was observed with a very good partial response. According to current literature, AHSCT is a reasonable treatment option for relapsed or resistant cases. In conclusion, our case is the first and unique who has undergone AHSCT. AHSCT is an effective and tolerable treatment for ectopic relapsed and refractory choriocarcinoma cases. [ABSTRACT FROM AUTHOR]