scholarly journals Refining the optimal chemotherapy regimen for good-risk metastatic nonseminomatous germ-cell tumors: a randomized trial of the Genito-Urinary Group of the French Federation of Cancer Centers (GETUG T93BP)

2007 ◽  
Vol 18 (5) ◽  
pp. 917-924 ◽  
Author(s):  
S. Culine ◽  
P. Kerbrat ◽  
A. Kramar ◽  
C. Théodore ◽  
C. Chevreau ◽  
...  
Keyword(s):  
Germ Cell ◽  
Randomized Trial ◽  
Chemotherapy Regimen ◽  
Germ Cell Tumors ◽  
Cancer Centers ◽  
Nonseminomatous Germ Cell Tumors ◽  
Good Risk

VAB-6: an effective chemotherapy regimen for patients with germ-cell tumors.

1986 ◽  
Vol 4 (10) ◽  
pp. 1493-1499 ◽  
Author(s):  
G J Bosl ◽  
R Gluckman ◽  
N L Geller ◽  
R B Golbey ◽  
W F Whitmore ◽  
...  
Keyword(s):  
Germ Cell ◽  
Relapse Rate ◽  
Chemotherapy Regimen ◽  
Germ Cell Tumors ◽  
Complete Response ◽  
Maintenance Chemotherapy ◽  
Residual Cancer ◽  
Minimum Duration ◽  
Total Survival ◽  
Nonseminomatous Germ Cell Tumors

One hundred sixty-six patients with germ-cell tumors (GCT) of the testis, retroperitoneum, and mediastinum were treated with cyclophosphamide, vinblastine, bleomycin, dactinomycin, and cisplatin (VAB-6), with and without maintenance chemotherapy. The overall complete response (CR) rate was 78%, 67% to chemotherapy alone, and 11% after chemotherapy and resection of viable residual cancer. The CR rate in all patients with seminoma was uniformly high, while the CR rate of patients with testicular nonseminomatous germ-cell tumors (79%) was superior to that of similar tumors of extragonadal origin (60%). The overall relapse rate was 12%, and was greater in tumors of extragonadal origin (21%) than in those of testicular origin (11%). Three relapses occurred after 2 years. Maintenance chemotherapy did not prolong either relapse-free or total survival. Toxicity was tolerable, and there were no treatment deaths. No Raynaud's phenomena have occurred, with a minimum duration since start of therapy of 36 months. VAB-6 is an effective chemotherapy regimen in patients with GCT with no treatment-related deaths and a majority of patients requiring only 3 months of treatment.

Randomized Trial of Two or Five Computed Tomography Scans in the Surveillance of Patients With Stage I Nonseminomatous Germ Cell Tumors of the Testis: Medical Research Council Trial TE08, ISRCTN56475197—The National Cancer Research Institute Testis Cancer Clinical Studies Group

2007 ◽  
Vol 25 (11) ◽  
pp. 1310-1315 ◽  
Author(s):  
Gordon J. Rustin ◽  
Graham M. Mead ◽  
Sally P. Stenning ◽  
Paul A. Vasey ◽  
Nina Aass ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Germ Cell ◽  
Randomized Trial ◽  
Poor Prognosis ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Ct Scans ◽  
Management Approach ◽  
National Cancer Research Institute ◽  
Nonseminomatous Germ Cell Tumors

PurposeSurveillance is a standard management approach for stage I nonseminomatous germ cell tumors (NSGCT). A randomized trial of two versus five computed tomography (CT) scans was performed to determine whether the number of scans influenced the proportion of patients relapsing with intermediate- or poor-prognosis disease at relapse.MethodsPatients with clinical stage I NSGCT opting for surveillance were randomly assigned to chest and abdominal CT scans at either 3 and 12 or 3, 6, 9, 12, and 24 months, with all other investigations identical in the two arms. Three of five patients were allocated to the two-scan schedule. Four hundred patients were required.ResultsTwo hundred forty-seven patients were allocated to a two-scan and 167 to five-scan policy. With a median follow-up of 40 months, 37 relapses (15%) have occurred in the two-scan arm and 33 (20%) in the five-scan arm. No patients had poor prognosis at relapse, but two (0.8%) of those relapsing in the two-scan arm had intermediate prognosis compared with 1 (0.6%) in the five-scan arm, a difference of 0.2% (90% CI, −1.2% to 1.6%). No deaths have been reported.ConclusionThis study can rule out with 95% probability an increase in the proportion of patients relapsing with intermediate- or poor-prognosis disease of more than 1.6% if they have two rather than five CT scans as part of their surveillance protocol. CT scans at 3 and 12 months after orchidectomy should be considered a reasonable option in low-risk patients.

scholarly journals Randomized trial of bleomycin, etoposide, and cisplatin compared with bleomycin, etoposide, and carboplatin in good-prognosis metastatic nonseminomatous germ cell cancer: a Multiinstitutional Medical Research Council/European Organization for Research and Treatment of Cancer Trial.

1997 ◽  
Vol 15 (5) ◽  
pp. 1844-1852 ◽  
Author(s):  
A Horwich ◽  
D T Sleijfer ◽  
S D Fosså ◽  
S B Kaye ◽  
R T Oliver ◽  
...  
Keyword(s):  
Germ Cell ◽  
Cell Cancer ◽  
Survival Rates ◽  
Germ Cell Tumors ◽  
Good Prognosis ◽  
Cancer Trial ◽  
European Organization ◽  
To Receive ◽  
Nonseminomatous Germ Cell Tumors ◽  
Good Risk

PURPOSE This prospective randomized multicenter trial was designed to evaluate the efficacy of carboplatin plus etoposide and bleomycin (CEB) versus cisplatin plus etoposide and bleomycin (BEP) in first-line chemotherapy of patients with good-risk nonseminomatous germ cell tumors. PATIENTS AND METHODS Between September 1989 and May 1993, a total of 598 patients with good-risk nonseminomatous germ cell tumors were randomized to receive four cycles of either BEP or CEB. In each cycle, the etoposide dose was 120 mg/m2 on days 1, 2, and 3, and the bleomycin dose was 30 U on day 2. BEP patients received cisplatin at 20 mg/m2/d on days 1 to 5 or 50 mg/m2 on days 1 and 2. For CEB patients, the carboplatin dose was calculated from the glomerular filtration rate to achieve a serum concentration x time of 5 mg/mL x minutes. Chemotherapy was recycled at 21-day intervals to a total of four cycles. RESULTS Of patients assessable for response, 253 of 268 (94.4%) of those allocated to receive BEP achieved a complete response, compared with 227 of 260 (87.3%) allocated to receive CEB (P = .009). There were 30 treatment failures in the 300 patients allocated to BEP and 79 in the 298 allocated to CEB (log-rank chi 2 = 26.9; P < .001), which led to failure-free rates at 1 year of 91% (95% confidence interval [CI], 88% to 94%) and 77% (95% CI, 72% to 82%), respectively. There were 10 deaths in patients allocated to BEP and 27 in patients allocated to CEB (log-rank chi 2 = 8.77; P = .003), which led to 3-year survival rates of 97% (95% CI, 95% to 99%) and 90% (95% CI, 86% to 94%), respectively. CONCLUSION With these drug doses and schedules, combination chemotherapy based on carboplatin was inferior to that based on cisplatin. This BEP regimen that contains moderate doses of etoposide and bleomycin is effective in the treatment of patients with good-prognosis metastatic nonseminoma.

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