Ifosfamide- and cisplatin-containing chemotherapy as first-line salvage therapy in germ cell tumors: Response and survival Journal Article
| Authors: | McCaffrey, J. A.; Mazumdar, M.; Bajorin, D. F.; Bosl, G. J.; Vlamis, V.; Motzer, R. J. |
| Article Title: | Ifosfamide- and cisplatin-containing chemotherapy as first-line salvage therapy in germ cell tumors: Response and survival |
| Abstract: | Purpose: To evaluate the efficacy and toxicity of ifosfamide- and cisplatin-containing chemotherapy as first-saline salvage treatment for patients with germ cell tumors (GCT). Patients and methods: Fifty-six patients with advanced GCT resistant to one prior cisplatin-containing regimen were treated with a salvage chemotherapy regimen of ifosfamide, cisplatin, and either vinblastine or etoposide (VeIP/VIP). Results: Twenty of 56 (36%) assessable patients achieved a complete response (CR). Thirteen (23%) are alive and continuously free of disease at a median follow-up time of 52 months; the median survival duration was 18 months. Among patients with a testis primary tumor site and a prior CR to first-line therapy, 65% are olive and 41% continuously disease-free, and the median survival time has not been reached. In contrast, for patients with an extragonadal primary tumor or with a testis primary tumor site and an incomplete response (IR) to first-line therapy, 31% are alive and 15% continuously free of disease, with a median survival time of 12 months (P < .03). Conclusion: Ifosfamide- and cisplatin-containing therapy achieves a durable CR in a minority of patients with resistant GCT as first-line therapy. Patients with a primary testis site who relapsed from a CR to first-line cisplatin therapy have a better prognosis than patients with an extragonadal primary tumor site or an IR to first-line therapy. Risk-directed clinical trials to improve response and survival in both subsets are warranted. |
| Keywords: | adolescent; adult; cancer survival; treatment outcome; middle aged; survival analysis; major clinical study; salvage therapy; cisplatin; advanced cancer; cancer combination chemotherapy; drug efficacy; antineoplastic agents; etoposide; antineoplastic combined chemotherapy protocols; antineoplastic agents, phytogenic; antineoplastic activity; ifosfamide; vinblastine; antineoplastic agents, alkylating; testicular neoplasms; germ cell tumor; germinoma; humans; human; male; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 15 |
| Issue: | 7 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1997-07-01 |
| Start Page: | 2559 |
| End Page: | 2563 |
| Language: | English |
| PUBMED: | 9215825 |
| PROVIDER: | scopus |
| DOI: | 10.1200/JCO.1997.15.7.2559 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 17 March 2017 -- Source: Scopus |
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