Germ cell tumors patients are unique because they are very young. Indeed, germ cell tumors are the most common solid tumors in young men. And most of them are diagnosed with early stage disease because we don’t have very good reliable biomarker to predict relapse. Most of these patients are followed on active surveillance. The active surveillance is mainly based on cross-sectional imaging, mainly CT scans and serum tumor markers that have limited accuracy to detect early relapse...
Germ cell tumors patients are unique because they are very young. Indeed, germ cell tumors are the most common solid tumors in young men. And most of them are diagnosed with early stage disease because we don’t have very good reliable biomarker to predict relapse. Most of these patients are followed on active surveillance. The active surveillance is mainly based on cross-sectional imaging, mainly CT scans and serum tumor markers that have limited accuracy to detect early relapse. So CT scan and serum tumor markers have limited sensitivity and specificity, especially in early stage disease, and there’s more so in seminoma than in non-seminoma. Moreover, we are exposing patients to the radiation from the CT scans when we use this kind of active surveillance tools. On the other hand, a biomarker like microRNA371 is highly specific for non-seminoma and seminoma germ cell tumors. It is not expressed by teratoma, which is a subgroup of non-seminoma. And all the retrospective studies and few prospective studies have demonstrated high accuracy to detect germ cell tumors. The first interim analysis I presented at ASCO 2026 in 224 patients, 69 relapses and 155 non-relapses in patients have shown very high specificity, 94%, high negative predictive value, 90%. Well, the sensitivity was lower than specificity, but it increased with stage at the relapse. Moreover, another important finding of our study was that if we do measure microRNA 371 at baseline, post-orchiectomy, the patients with a post-orchiectomy microRNA 371 positive result in a significantly shorter relapse-free survival compared to the patients who are negative immediately post-orchiectomy, with a hazard ratio of 9.9 that was very highly statistically significant.
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