Cisplatin and etoposide combination chemotherapy for locally advanced or metastatic thymoma. A phase II study of the European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group.

Giaccone, Giuseppe; Ardizzoni, Andrea; Kirkpatrick, A.; Clerico, Mario; Sahmoud, Tarek; Zandwijk, Nico van

doi:10.1200/jco.1996.14.3.814

Cited by 195 publications

(102 citation statements)

References 26 publications

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“…Non-anthracycline approaches contained regimens such as VIP , ETP -CDDP (Giaccone et al, 1996) and paclitaxel -carboplatin (Lemma et al, 2008) tended to yield lower response rates of 32 -56% as compared with regimens including anthracycline (Table 3). It might, thus, be suggested that both anthracycline and platinum should, thus, be included in thymoma chemotherapy, at least in current clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, thymomas are generally reported to be chemotherapy-sensitive tumours, with response rates of 50 -70% to combination chemotherapy (Fornasiero et al, 1990;Loehrer et al, 1994Loehrer et al, , 1997Loehrer et al, , 2001Giaccone et al, 1996;Berruti et al, 1999;Kim et al, 2004;Lucchi et al, 2006;Yokoi et al, 2007). Active agents include cisplatin (CDDP), vincristine (VCR), doxorubicin (ADM), etoposide (ETP), cyclophosphamide (CPM) and ifosfamide (IFX).…”

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A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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BACKGROUND: To evaluate the safety and efficacy of dose-dense weekly chemotherapy in the treatment of advanced thymoma. METHODS: Subjects comprised patients with histologically documented chemotherapy-naïve thymoma with stage-IVa or IVb disease. Thymic carcinoma, carcinoid or lymphoma cases were excluded. Patients received 9 weeks of chemotherapy: cisplatin (25 mg m À2 ) on weeks 1 -9; vincristine (1 mg m À2 ) on weeks 1, 2, 4, 6 and 8; and doxorubicin (40 mg m À2 ) and etoposide (80 mg m À2 ) on days 1 -3 of weeks 1, 3, 5, 7 and 9. Chemotherapy courses were supported by granulocyte colony-stimulating factor. Post-protocol local therapy was allowed. RESULTS: From July 1997 to March 2004, 30 patients were entered. Three were ineligible due to different histology. Chemotherapyassociated toxicity was mainly haematological and was well tolerated, with no deaths due to toxicity, and 87% of patients completed the planned 9-week regimen. Overall response rate was 59%, with 16 of the 27 eligible patients achieving partial response. Median progression-fee survival (PFS) was 0.79 years (95% confidence interval: 0.52 -1.40 years), and PFS at 1 and 2 years was 37 and 15%, respectively. Overall survival rates at 2 and 5 years were 89 and 65%, respectively. CONCLUSION: In stage-IV thymoma patients, weekly dose-dense chemotherapy offers similar activity to conventional regimens.

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Section: Discussionmentioning

confidence: 99%

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A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

et al. 2009

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“…A small study of cisplatin and etoposide in patients with metastatic or recurrent disease resulted in a median survival of 4.3 years. 4 There remains no standard salvage regimen for relapsed thymomas, however. Salvage strategies have included cytokine therapy, where responses to IL-2 have been reported.…”

Section: Discussionmentioning

confidence: 99%

“…This approach was supported by a trial conducted by the EORTC which reported a 50% response rate in patients treated with conventional dosage cisplatin plus etoposide in advanced thymoma. 4 …”

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High-dose carboplatin with etoposide in patients with recurrent thymoma: the Indiana University experience

Hanna

Gharpure²,

Abonour

et al. 2001

Bone Marrow Transplant

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Summary:Thymoma is a chemotherapy-sensitive tumor with a 30-50% 5-year survival in previously untreated patients. Unfortunately, durable CRs with salvage chemotherapy are rarely observed. We initiated a phase II trial of high-dose carboplatin and etoposide in patients with relapsed thymoma or thymic carcinoma. All patients had progressive disease (PD) after initial or salvage chemotherapy, but were not cisplatin-refractory. PBSCs were mobilized using 10 g/kg/day G-CSF. Patients received carboplatin 700 mg/m 2 and etoposide 750 mg/m 2 i.v. on days −5, −4, −3. Five patients were enrolled and evaluated after tandem transplants 4 weeks apart. All patients had pleural-based and lung parenchymal metastasis, one or two prior surgeries and two or more courses of prior cisplatin-based chemotherapy regimens. Chemotherapy was well tolerated, although grade IV hematological toxicity occurred in all patients. Progression-free survival following HDC ranged from 3.5 to 16.5 months. One patient maintained a CR for 12.8 months, then died from an unrelated cause. With a minimum of 2 years follow-up for all patients, three of five patients remain alive at 26+, 36+, and 49+ months. High-dose carboplatin and etoposide in relapsed thymoma is feasible with acceptable toxicity; however, these limited data do not appear superior to standard-dose salvage therapy. Bone Marrow Transplantation (2001) 28, 435-438. Keywords: autologous stem cell transplantation; thymoma; relapsed disease Thymomas are infrequent tumors, but are the most common neoplasm of the anterior mediastinum. 1 They are chemosensitive with objective responses observed with single agent and combination chemotherapy. For patients with unresectable locally advanced disease, cisplatin, doxorubicin plus cyclophosphamide (PAC) produced an overall response rate of 70% prior to radiation therapy and 5-year overall survival of 52.5% in a small prospective intergroup trial. 2 However, durable CRs are rarely observed with standard salvage chemotherapy for relapsed disease.Indiana University has experience with high-dose carboplatin and etoposide in the treatment of high risk and relapsed germ cell tumors. Patients with testicular cancer who are not cured with cisplatin-combination chemotherapy and aggressive surgical extirpation can achieve long-term remissions and cures with high-dose carboplatin and etoposide followed by peripheral blood stem cell (PBSC) transplantation. 3 Based on the germ cell model, we initiated this phase II study to investigate the efficacy of high-dose carboplatin and etoposide with PBSCT in patients with recurrent thymoma or thymic carcinoma. This approach was supported by a trial conducted by the EORTC which reported a 50% response rate in patients treated with conventional dosage cisplatin plus etoposide in advanced thymoma. 4

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“…From the clinical point of view, advanced tumor resectability is judged on the basis of radiological appearance on thoracic chemotherapy (CT) scan/MRI (tumor size, invasiveness into adjacent anatomical structures) and usually it is strictly surgeon's dependent. TETs' strong chemosensitivity, as demonstrated in unresectable/metastatic setting (cisplatin regimens were, in fact effective in 50% to 90% of CT-naive patients) (15)(16)(17), led possible, in the last two decades, some retrospective/prospective clinical studies of induction CT and RT in locally advanced TETs. Those studies were, unfortunately limited by: (I) the retrospective design (in the majority); (II) the limited number of patients; and (III) the absence of an upfront surgery control group.…”

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confidence: 99%

Multimodality therapy for locally-advanced thymic epithelial tumors: where are we now?

et al. 2016

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Cisplatin and etoposide combination chemotherapy for locally advanced or metastatic thymoma. A phase II study of the European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group.

Abstract: The combination of cisplatin and etoposide is highly effective and well tolerated in advanced thymoma. The investigation of this combination in a neoadjuvant setting in unresectable invasive thymoma is warranted.

Cited by 195 publications

References 26 publications

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

A phase-II trial of dose-dense chemotherapy in patients with disseminated thymoma: report of a Japan Clinical Oncology Group trial (JCOG 9605)

High-dose carboplatin with etoposide in patients with recurrent thymoma: the Indiana University experience

Multimodality therapy for locally-advanced thymic epithelial tumors: where are we now?

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