High-dose therapy including carboplatin adjusted for renal function in patients with relapsed or refractory germ cell tumour: outcome and prognostic factors

Lyttelton, Matthew; Newlands, E. S.; Giles, Chrissy; Bower, Mark; Guimarães, António; O'Reilly, S.M.; Rustin, G. J. S.; Samson, Diana; Kanfer, Edward

doi:10.1038/bjc.1998.275

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…Previous reports (Beyer et al, 1996;Lyttelton et al, 1998), including our current data, have shown that patients with cisplatin-refractory disease have significantly poorer outcomes than those who are cisplatin sensitive. However, it is noticeable that two patients presented here with cisplatin-refractory disease have survived long term (over 44 months), one of whom was absolutely refractory.…”

Section: Discussionsupporting

confidence: 51%

“…The predicted long-term event-free and overall survivals were 29 and 39%, respectively. Such figures have largely been reproduced by other groups (Siegert et al, 1994;Flechon et al, 1999;Nichols and Maziarz, 1999), including our own (Lyttelton et al, 1998). Where patients received high-dose chemotherapy exclusively as part of first salvage treatment, survival figures are improved, with nearly 60% of patients alive at a median follow-up of 39 months (Bhatia et al, 2000).…”

Section: Discussionmentioning

confidence: 55%

“…We have previously treated 31 patients with relapsed or refractory testicular GSTs with the Carbop-EC regime that lacks paclitaxel but is otherwise the same as Carbop-EC-T (Lyttelton et al, 1998). The previous cohort of patients did not differ significantly from the current cohort in any of the characteristics detailed in Table 1 (See supplementary Table 3), and the addition of paclitaxel was not associated with any increase in nonpulmonary toxicity (including the rate of neutrophil recovery, the requirement for renal dialysis and the incidence of grade III/IV mucositis).…”

Section: Resultsmentioning

confidence: 99%

“…Carbop-EC-T is a derivative of the regime that we have described previously (Lyttelton et al, 1998) Paclitaxel high-dose chemotherapy for GCTs IA McNeish et al days À5 and À3 (total dose 120 mg kg À1 ). Mesna was given to all patients to prevent urological toxicity.…”

Section: Chemotherapymentioning

confidence: 99%

“…We have previously reported the outcome of 31 heavily pretreated patients who received high-dose carboplatin, etoposide and cyclophosphamide (Carbop-EC) followed by peripheral blood stem cell rescue (Lyttelton et al, 1998). There was one treatment-related death and the probability of event-free and overall survival at 3 years was 30 and 42%, respectively.…”

mentioning

confidence: 99%

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Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours

et al. 2004

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High-dose regimes containing etoposide, carboplatin and an oxazaphospharine can salvage 30 -40% of patients with relapsed or refractory male germ cell tumours (GCTs). The additional benefit of paclitaxel in such high-dose therapy has not been tested. Between March 1995 and November 2002, 36 male GCT patients were treated with Carbop-EC-T (paclitaxel 75 mg m À2 , etoposide 450 mg m À2 , carboplatin AUC 10 on days À7, À5 and À3 and cyclophosphamide 60 mg kg À1 on days À5 and À3) followed by peripheral blood stem cell infusion (day 0). The 1-year overall survival rate for all patients is 67% (median follow-up 29 months). For the 24 patients with cisplatin-sensitive disease, the 1-year overall and event-free survivals are 88 and 64%, respectively. For those with cisplatin refractory or absolutely refractory disease, the 1-year overall survival is 25%. In all, 12 patients relapsed at a median duration of 5 months, 11 of whom have died. There were also six treatment-related deaths, five associated with pneumonitis. Pulmonary toxicity has been reported with paclitaxel in other high-dose regimes. Since altering our protocol so that paclitaxel is infused over 24 h with steroid prophylaxis, only one of 18 patients (13 testicular GCTs and five other tumour types) has had a treatment-related death. Our results suggest that Carbop-EC-T may enable a greater proportion of patients with relapsed and refractory GCTs to enter long-term remission.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 55%

Section: Resultsmentioning

confidence: 99%

Section: Chemotherapymentioning

confidence: 99%

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confidence: 99%

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Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours

et al. 2004

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Salvage treatment for testicular cancer with standard- or high-dose chemotherapy: a systematic review of 59 studies

et al. 2017

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Relapsed germ cell tumor (GCT) is a highly curable cancer with standard-dose platinum-based chemotherapy (CT); however, high-dose CT (HDCT) is seldom used as salvage therapy instead or after conventional CT. We conducted a systematic review of published trials to compare outcomes between standard-dose CT and HDCT in patients with relapsed GCT after first-line therapy for advanced disease. A literature search was carried out in multiple electronic databases (PubMed, Embase, Scopus, Web of Science, and The Cochrane Library), and studies reporting salvage treatment of relapsed GCT with standard-dose or carboplatin-etoposide-based HDCT were selected. Overall response rate, median overall survival (OS), and the 1-, 2-, 3-, and 5-year OS rates were pooled, and the significance of difference between arms was assessed with a Chi-square test. Twenty-nine standard-dose and 31 HD studies were included in the meta-analysis. For standard-dose CT versus HDCT, there was no significant difference in median OS (14.8 months and 24.09 months, respectively; P = 0.09) or in 1-, 2-, 3-, or 5-year survival rate (standard-dose CT, 64.2, 63.6, 45.1, and 43%, respectively; HDCT, 63.7, 51.2, 46.7, and 45%, respectively; P = 0.9, P = 0.4, P = 0.75, and P = 0.06). Conventional dose regimens and HDCT were associated with comparable efficacy when used as salvage therapies in relapsed GCTs as second-line therapy or beyond. However, the selection of ideal candidates for more or less intensive treatments deserves further research in the near future.

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Platinum-containing cytostatic drugs

2006

Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions

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High-dose therapy including carboplatin adjusted for renal function in patients with relapsed or refractory germ cell tumour: outcome and prognostic factors

Cited by 12 publications

References 16 publications

Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours

Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours

Salvage treatment for testicular cancer with standard- or high-dose chemotherapy: a systematic review of 59 studies

Platinum-containing cytostatic drugs

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