Single agent carboplatin for CS IIA/B testicular seminoma. A phase II study of the German Testicular Cancer Study Group (GTCSG)

Krege, Susanne; Boergermann, C.; Baschek, R.; Hinke, Axel; Pottek, Tobias; Kliesch, Sabine; Dieckmann, K.-P.; Albers, Peter; Knutzen, B.; Weinknecht, S.; Schmoll, H.-J.; Beyer, Jörg; Ruebben, Herbert

doi:10.1093/annonc/mdj039

Cited by 77 publications

(32 citation statements)

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“…However, the relationship among the dose intensity, total number of cycles, and treatment outcome (including the rate of relapse) is very controversial. [4][5][6][7][8]16 Although there is no strict evidence for the efficacy of prolonged administration of carboplatin, including maintenance therapy, long-term carboplatin at 4 AUC may achieve therapeutic efficacy with minimal occurrence of serious adverse events.…”

Section: Discussionmentioning

confidence: 99%

Long-term administration of single-agent carboplatin (AUC 4) for advanced testicular seminoma safely achieved complete response in an 80-year-old man with chronic heart failure: A case report

Fukuhara

Yagi

Ando

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e931-3. http://dx.doi.org/10.5489/cuaj.2089 Published online December 15, 2014. AbstractCarboplatin is often used instead of cisplatin as an alternative treatment for advanced testicular cancer. However, the safety, optimal dose, and optimal duration of this agent are unclear in patients with cardiac complications. We report the safety and effectiveness of long-term single-agent carboplatin for the treatment of testicular cancer in a patient with chronic heart failure (CHF). An 80-year-old man was referred to our institution for evaluation of painless swelling of the left scrotum. Computed tomography revealed lung metastases. Left radical inguinal orchiectomy was performed, and pathologic examination revealed a pure seminoma. Because he had CHF, there was high possibility of onset of acute heart failure secondary to fluid administration. Thus, single-agent carboplatin (AUC 4) was selected for therapy. A complete response was achieved after 8 of 13 cycles, and no serious adverse events occurred, including cardiac problems. Neither recurrence nor metastasis was detected during the 6-month follow-up. Low-dose, long-term carboplatin is likely effective for patients who are unfit for cisplatin administration because of comorbidities, especially CHF.

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Section: Discussionmentioning

confidence: 99%

Long-term administration of single-agent carboplatin (AUC 4) for advanced testicular seminoma safely achieved complete response in an 80-year-old man with chronic heart failure: A case report

Fukuhara

Yagi

Ando

et al. 2014

CUAJ

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“…Giannis et al [28] also concluded that patients with low-volume metastatic stage IIA and IIB seminoma can be treated by 4 cycles of PEB instead of radiotherapy with the risk of diverse toxicity effect. A different chemotherapy strategy was studied by Krege et al [29], investigating the use of single-agent carboplatin at a dose of AUC 7 in 108 patients with seminoma stages IIA (3 cycles) and IIB (4 cycles). Complete response, partial response, no response and progressive disease were displayed in 81, 16, 2 and 1%, prospectively.…”

Section: Discussionmentioning

confidence: 99%

“…Complete response, partial response, no response and progressive disease were displayed in 81, 16, 2 and 1%, prospectively. Therefore, single-agent carboplatin chemotherapy (4 cycles) did not sufficiently eliminate retroperitoneal metastases and was not recommended in stage IIA/IIB seminoma [29]. Combining carboplatin and radiotherapy for seminoma stage IIA/IIB appears to have additional toxicity, but reduces the relapse rate on long-term follow-up with a 5-year relapse-free survival of 92.3% (stage IIA) and 100% (stage IIB) compared to radiotherapy alone (5-year relapse-free survival of 84.9% in stage IIA and 69.4% in stage IIB) [30].…”

Section: Discussionmentioning

confidence: 99%

Two Cycles of Cisplatin-Based Chemotherapy for Low-Volume Stage II Seminoma: Results of a Retrospective, Single-Center Case Series

et al. 2012

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Background: To report on the oncological outcome and toxicity of patients treated with 2 cycles of cisplatin-based chemotherapy for low-volume metastatic stage II seminoma. Methods: We retrospectively identified a case series of 15 patients with seminoma stage IIA (26.7%) and IIB (73.3%) who underwent chemotherapy consisting of 2 cycles of cisplatin, etoposide and bleomycin (PEB) (cisplatin 20 mg/m² on days 1–5, etoposide 100 mg/m² on days 1–5, bleomycin 30 mg on days 1, 8 and 15) according to patient preference (refusing a 3rd cycle of PEB) or institutional practice in the last decades. Complete staging before chemotherapy was available in all patients. Patient age, the side and diameter of the primary tumor, the size of the lymph nodes before and after chemotherapy, acute and late toxicity of chemotherapy, the incidence of second malignancies, the relapse-free rate and cancer-specific mortality were recorded. Results: Chemotherapy was well tolerated and no episode of febrile neutropenia occurred. Thrombocytopenia grade 4 was not seen in any patient, while leukopenia grade 4 was observed in 4 (26.6%) patients. The mean (range) lymph node size decreased significantly from 2.54 cm (1.1–4.0) before chemotherapy to 0.75 cm (0.4–2.2) after chemotherapy (p < 0.001). After a median (range) follow-up of 60 (13–185) months, no patient had relapsed, no patient had died as a result of seminoma and second malignancy was seen in only 1 (6.6%) patient. Conclusions: These excellent long-term results from a retrospective case series of 2 cycles of PEB in stage IIA/IIB seminoma patients represent a hint for further research with a view to reducing treatment burden. However, these incidental findings should be studied in prospective trials prior to drawing any conclusions.

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“…Hier zeigte sich hinsichtlich der Rezidivrate kein Vorteil gegenüber der Bestrahlung [15]. Als ungünstig erwies sich, dass nahezu alle Rezidive die primären Metastasenlokalisationen betrafen, wohingegen Rezidive nach Bestrahlung in der Regel außer-halb des Bestrahlungsfeldes auftreten [3].…”

Section: Seminom Cs Iia/bunclassified

Chemotherapie des Hodentumors

Krege

Hartmann

Rübben

2006

Urologe

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Platinum-based polychemotherapy has increased the cure rate in testicular cancer dramatically: at first, chemotherapy was mainly used in advanced disease. Recently it has also become common in low-stage disease, though other therapeutic options are equivalent. Risk factors might help to find the right decision. The success of treatment in patients with metastatic disease results from the combination of chemotherapy and secondary surgery. High-dose chemotherapy for patients with poor prognosis or recurrent disease is being evaluated in clinical trials. Concerning the success in these stages prognostic factors are of special importance. Patients with advanced-stage nonseminoma need residual tumor resection after chemotherapy if no complete remission could be achieved. The therapist should be aware of the indication for and schedule of chemotherapy, its side effects, and supportive care.

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Single agent carboplatin for CS IIA/B testicular seminoma. A phase II study of the German Testicular Cancer Study Group (GTCSG)

Abstract: Four cycles of single agent carboplatin AUC 7 do not safely eradicate retroperitoneal metastases in patients with stage IIA/B seminoma.

Cited by 77 publications

References 20 publications

Long-term administration of single-agent carboplatin (AUC 4) for advanced testicular seminoma safely achieved complete response in an 80-year-old man with chronic heart failure: A case report

Long-term administration of single-agent carboplatin (AUC 4) for advanced testicular seminoma safely achieved complete response in an 80-year-old man with chronic heart failure: A case report

Two Cycles of Cisplatin-Based Chemotherapy for Low-Volume Stage II Seminoma: Results of a Retrospective, Single-Center Case Series

Chemotherapie des Hodentumors

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