Delphine Garbay

Publications (2)3.7 Total impact

• Article: Bone marrow metastases in a patient with primary mediastinal non-seminomatous germ cell tumor - an unusual pattern of relapse.

  Delphine Garbay, Françoise Durrieu, Binh Bui, Antoine Italiano
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  ABSTRACT: Bone marrow is a very unusual site of metastasis for germ cell tumors. We report the case of a 21-year-old male patient who was treated with chemotherapy and secondary surgery for a primary mediastinal non-seminomatous germ cell tumor (NSGCT). The patient achieved complete remission. However, 4 months after completion of therapy, he complained of rapidly worsening bone pain. No evidence for disease relapse was found in the computed tomography scan of thorax and abdomen, magnetic resonance imaging of the spine, or bone scan. A blood test revealed pancytopenia and elevated serum tumor markers. A bone marrow aspirate showed infiltration by tumor cells positive for AE1/AE3 and AFP confirming the diagnosis of isolated bone marrow metastatic relapse. Salvage chemotherapy was started and resulted in a rapid decrease of serum tumor markers. However, pancytopenia did not improve and the patient died of severe sepsis 3 weeks later. We report here the first case of isolated bone marrow metastatic relapse of an NSGCT. 2 other cases of bone marrow metastasis in patients with NSGCT have been reported. In these 2 cases, as in our patient, the primary site was not testicular but mediastinal suggesting a non-fortuitous association.
  Onkologie 01/2012; 35(1-2):40-2. · 0.87 Impact Factor
• Source

  Available from: Antoine Italiano

  Article: "Metronomic" chemotherapy in advanced soft tissue sarcomas.

  Antoine Italiano, Maud Toulmonde, Barbara Lortal, Eberhard Stoeckle, Delphine Garbay, Guy Kantor, Michèle Kind, Jean-Michel Coindre, Binh Bui
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  ABSTRACT: Angiogenesis plays a crucial role in metastatic progression of soft tissue sarcomas (STS). Endothelial cells are the primary target of metronomic chemotherapy. We report the safety and the efficacy of metronomic chemotherapy in metastatic STS patients. The medical charts of 26 metastatic STS patients treated at Institut Bergonie (Bordeaux, France) with metronomic etoposide (100 mg/day orally for 21 consecutive days, repeated every 4 weeks) were reviewed by two independent investigators. Median age was 49. All but three patients received prior treatment with doxorubicin and/or ifosfamide. One patient (4%) had partial response and 11 patients (42%) had stable disease for more than 24 weeks. The 6-month and the 1-year progression-free survival rates were 42% [95% CI: 23; 61] and 23% [95% CI: 7; 39], respectively. The 6-month and the 1-year overall survival rates were 69% [95% CI: 51; 87] and 31% [95% CI: 13; 49], respectively. Two patients experienced grade 4 febrile neutropenia and one of them died of sepsis. In this series, metronomic etoposide was associated with significant clinical activity in STS. Further prospective investigations are necessary to identify those patients who are more likely to benefit from this strategy.
  Cancer Chemotherapy and Pharmacology 02/2010; 66(1):197-202. · 2.83 Impact Factor