High-dose chemotherapy with hematologic rescue for high-risk non-seminomatous germ cell tumors

1991 ◽  
pp. 311-313
Author(s):  
J. L. Pico ◽  
J. P. Droz ◽  
E. Zambon ◽  
M. Montastruc ◽  
A. Gouyette ◽  
...  
Keyword(s):  
High Risk ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose

The efficacy of irinotecan, paclitaxel, and oxaliplatin (IPO) in relapsed germ cell tumours: A non-cisplatin-based regimen.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4529-4529
Author(s):  
Waleed Badreldin ◽  
Simon Chowdhury ◽  
Stephen John Harland ◽  
Danish Mazhar ◽  
Thomas Powles ◽  
...  
Keyword(s):  
High Risk ◽  
Germ Cell ◽  
Prognostic Score ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Grade 3 ◽  
Line Setting ◽  
Very High ◽  
Good Risk

4529 Background: Cisplatin-based chemotherapy with or without high dose chemotherapy remains the standard approach in managing relapsed germ cell tumors (GCT). The feasibility of IPO was first described in 2006.Non cisplatin-based therapies offer the advantage of differing side effect profiles which may be useful to certain patients.Here we describe the outcome of an expanded cohort of these patients. Methods: The results of 72 consecutive patients were reviewed (18% had metastatic mediastinal GCTs). IPO was used either as 2nd line treatment (n=29) of which 20 had HDCT or 3rd line (n=43) of which 32 had HDCT. IPO consisted of oxaliplatin 100mg/m2, irinotecan 200mg/m2 and weekly pac litaxel 80mg/m2 ( IPO) every 3 weeks for 3-4 cycles with the intention of high dose carboplatin , thiotepa and topotecan as consolidation (HDCT). Results: The 2 year PFS and 3 year OS for the whole cohort was 28.4% (95%CI 17.3-40.5%) and 31.6% (95%CI: 20.1-43.8 %) respectively. The overall response was as follows; CR – 3%, m-ve PR 41%, m+ve PR 18%, SD 17%, PD 20%. In the second line setting, the 2 year PFS was 41.8% (95%CI: 21.7-60.8%) and 3y OS 45.8% (95%CI: 24.2-65.1%). The 2 year PFS according to the IGCCCG2 prognostic score was Intermediate = 34%, High risk =50% and very high risk = 30%. In the 3rd line setting the 2 year PFS was 20.9% (95%CI 9.5-35.4%) and 3 year OS was 23.8% (95%CI 11.7-38.2). For HDCT the 2 y PFS was good risk= 52%, Intermediate =29% and poor risk= 0%. There were 2 treatment related deaths from IPO, and 4 from HDCT. Grade 3 or 4 toxicities were as follows (>5%): neutropenia 35%, thrombocytopenia 18%, infection 15%, diarrhea 11%, lethargy 8%. Conclusions: IPO is a safe, non-nephrotoxic day care regimen which produces encouraging responses particularly in high risk cases. Where cisplatin is contra-indicated this is may be a useful alternative.

scholarly journals High-dose chemotherapy followed by stem cell rescue for high-risk germ cell tumors: the Stanford experience

2008 ◽  
Vol 43 (7) ◽  
pp. 547-552 ◽  
Author(s):  
R Agarwal ◽  
C C Dvorak ◽  
K E Stockerl-Goldstein ◽  
L Johnston ◽  
S Srinivas
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Stem Cell Rescue

scholarly journals Second-line high-dose chemotherapy in patients with mediastinal and retroperitoneal primary non-seminomatous germ cell tumors: the EBMT experience

2005 ◽  
Vol 16 (1) ◽  
pp. 146-151 ◽  
Author(s):  
U. De Giorgi ◽  
T. Demirer ◽  
H. Wandt ◽  
C. Taverna ◽  
W. Siegert ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Second Line

High-Dose Chemotherapy for Recurrent Ovarian Germ Cell Tumors

2015 ◽  
Vol 33 (2) ◽  
pp. 226-227 ◽  
Author(s):  
Natraj Reddy Ammakkanavar ◽  
Daniela Matei ◽  
Rafat Abonour ◽  
Lawrence H. Einhorn
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose

scholarly journals The Role of Salvage High-Dose Chemotherapy in Relapsed Male Germ Cell Tumors

2018 ◽  
Vol 41 (6) ◽  
pp. 365-369 ◽  
Author(s):  
Christoph Oing ◽  
Anja Lorch
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
Male Germ Cell ◽  
High Dose

A randomized trial of standard chemotherapy v a high-dose chemotherapy regimen in the treatment of poor prognosis nonseminomatous germ-cell tumors.

1988 ◽  
Vol 6 (6) ◽  
pp. 1031-1040 ◽  
Author(s):  
R F Ozols ◽  
D C Ihde ◽  
W M Linehan ◽  
J Jacob ◽  
Y Ostchega ◽  
...  
Keyword(s):  
Germ Cell ◽  
Dose Regimen ◽  
Standard Therapy ◽  
Poor Prognosis ◽  
Cell Cancer ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
High Dose Regimen ◽  
Disease Free

We performed a prospective randomized trial of a high-dose chemotherapy regimen v standard cisplatin-based chemotherapy in poor prognosis nonseminomatous germ-cell cancer patients. The high-dose regimen consisting of twice the standard dose of cisplatin (P), along with vinblastine (Ve), bleomycin (B), and the epipodophylotoxin etoposide (VP-16) (V) (PVeBV) was compared to the classic regimen with normal dose cisplatin, vinblastine, and bleomycin (PVeB). Eligibility criteria included large abdominal masses, liver metastases, multiple pulmonary metastases, brain metastases, marked elevations in serum tumor markers (alpha-fetoprotein greater than 1,000 ng/mL or the beta-subunit of human chorionic gonadotropin greater than 10,000 mIU), unfavorable histology (pure choriocarcinoma), or extragonadal germ-cell tumors. Fifty-two consecutive patients with poor prognostic features were randomized to receive either PVeBV or PVeB. The median follow-up is 4 years. Treatment with the high-dose regimen increased the complete remission rate (88% v 67%, P = .14) and was associated with a lower relapse rate (17% v 41%, P = .2). The median survival of patients receiving standard therapy was 30 months, while the median survival for patients receiving the high-dose regimen has not been reached. Actuarial 5-year survival for patients treated with the high-dose regimen is 78%, compared with 48% for patients receiving standard therapy (two-sided Mantel-Cox test = .06). Disease-free survival was also superior for patients randomized to PVeBV (P = .03). Sixty-eight percent of patients (23 of 34) randomized to PVeBV are alive and continuously disease-free, compared with 33% (six of 18) for PVeB (P = .02). The major difference in toxicity between the high-dose regimen and standard therapy was the severity of myelosuppression and the incidence of severe hearing loss. Ninety-one percent of patients treated with PVeBV had a WBC count less than 1,000/microL, compared with 50% of patients receiving PVeB (P less than .05). Hearing aids were recommended for 12 patients who received PVeBV and two who received PVeB. The increased effectiveness of the PVeBV regimen in poor prognosis germ-cell cancer patients may relate to the double-dose cisplatin, the addition of VP-16, or to a synergistic effect of these two drugs.

The role of high-dose chemotherapy in the management of germ cell tumors

2014 ◽  
Vol 26 (3) ◽  
pp. 284-293 ◽  
Author(s):  
Diogo A. Bastos ◽  
Darren R. Feldman
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
High Dose Chemotherapy ◽  
High Dose
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