Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ-cell tumors

Abstract

Antitumor activity against intracranial malignant teratoma by combination chemotherapy with cisplatin and etoposide was evaluated in experimental and clinical studies. A human teratoma cell line (Tera 2) was exposed in vitro to cisplatin and/or etoposide, after which cell growth inhibition and alterations of deoxyribonucleic acid (DNA) histograms were observed. The results indicated that a synergistic cytotoxic effect was achieved by use of both agents in combination. Four cases of recurrent intracranial germ-cell tumor (three malignant teratomas and one germinoma) were treated with cisplatin and etoposide. With this combination therapy, regression of the tumor was observed in all four cases (three complete and one partial), for a total response rate of 100%. During a follow-up period of 9 to 22 months, no recurrence or progression has been noted in three of these cases.

Effects of Therapy on Anterior Pituitary Functions in Patients with Primary Intracranial Germ Cell Tumor.

“…The radio-resistance of non-germinomatous germ cells in nature has led to the use of combination chemotherapy [8,[17][18][19][20]. Although long-term follow-up studies have not sufficiently been made, excellent response rates have been reported when cisplaitin and etoposide were given to 12 patients with newly diagnosed or recurrent germ cell tumors, suggesting that this chemotherapy is successful in the treatment of both geninoma and non-germinatous germ cell tumors [12]. However, the effects of this chemotherapy on pre-existing hormonal abnormalities were not reported.…”

“…We used CBDCA to reduce the nephrotoxicity of cisplatin. Etoposide, which was reported to be effective in treating malignant tumors [12,24], was combined with CBDCA.…”

“…Actually, chemotherapy has been reported to be successfully used in treating intracranial germ cell tumors. The overall response rate exceeds 90% [12,13]. However, the chemotherapy-induced changes in endocrine functions remain to be clarified.…”

Pre‐radiation chemotherapy with response‐based radiation therapy in children with central nervous system germ cell tumors: A report from the Children's Oncology Group

“…Studies in new and relapsed patients found responses and/or improved survival after platinum-containing regimens [17][18][19][20][21][22][23][24][25], with one study suggesting synergy with etoposide [26]. Alkylating agents, such as cyclophosphamide (CPM) also were added with apparent efficacy in some trials [12,14,23].…”

Combined treatment modality for intracranial germinomas: results of a multicentre SFOP experience

“…Using systemic chemotherapy, promising response rates have been achieved in newly diagnosed and relapsing patients with cyclophosphamide (Allen et al, 1987) or cisplatin-based regimens (Kobayashi, 1989;Patel et al, 1992). Consequently, new treatment strategies have been developed to use primary chemotherapy to avoid or to reduce radiotherapy in good responders.…”