The role of ifosfamide plus cisplatin‐based chemotherapy as salvage therapy for patients with refractory germ cell tumors Journal Article


Authors: Motzer, R. J.; Cooper, K.; Geller, N. L.; Bajorin, D. F.; Dmitrovsky, E.; Herr, H.; Morse, M.; Fair, W.; Sogani, P.; Russo, P.; Bosl, G. J.
Article Title: The role of ifosfamide plus cisplatin‐based chemotherapy as salvage therapy for patients with refractory germ cell tumors
Abstract: A prospective study of four cycles of etoposide with ifosfamide and cisplatin (VIP) chemotherapy was conducted in 42 germ cell tumor (GCT) patients who were refractory to cisplatin with etoposide/vinblastine‐based therapy. Forty patients were evaluable for response. Ten patients (25%) had a complete response: seven to chemotherapy alone and an additional three patients after surgical resection of viable GCT. With a median follow‐up of 15 months, four complete responders relapsed, and six patients (15%) remain in remission. Hematologic and nephrotoxicity were moderately severe. Durable complete responses with VIP as second salvage were achieved and suggests that ifosfamide adds efficacy to standard first‐salvage therapy. the observed nephrotoxicity and myelotoxicity are considerations in the design of ifosfamide‐cisplatin‐based regimens. Hematopoietic growth factors may be useful in ameliorating myelotoxicity. the early use of ifosfamide‐based chemotherapy may reduce the nephrotoxicity exacerbated by prior cisplatin. A trial of VIP as first salvage after a relapse from a complete response to platinum‐based induction therapy is warranted. the modest proportion of patients who achieve a durable remission to VIP as second salvage emphasizes the need for more efficacious salvage therapy for patients who do not achieve a durable complete response. Copyright © 1990 American Cancer Society
Keywords: adolescent; adult; clinical article; cisplatin; prospective studies; nephrotoxicity; etoposide; antineoplastic combined chemotherapy protocols; ifosfamide; testicular neoplasms; neoplasms, germ cell and embryonal; mesna; germ cell tumor; intravenous drug administration; bone marrow toxicity; middle age; human; male; female; priority journal; article; support, non-u.s. gov't; support, u.s. gov't, p.h.s.
Journal Title: Cancer
Volume: 66
Issue: 12
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1990-12-15
Start Page: 2476
End Page: 2481
Language: English
DOI: 10.1002/1097-0142(19901215)66:12<2476::Aid-cncr2820661206>3.0.Co;2-d
PUBMED: 2174300
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 27 January 2020 -- Source: Scopus
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MSK Authors
  1. Paul Russo
    581 Russo
  2. Dean Bajorin
    657 Bajorin
  3. Robert Motzer
    1243 Motzer
  4. Pramod C Sogani
    75 Sogani
  5. Harry W Herr
    594 Herr
  6. George Bosl
    430 Bosl
  7. William R Fair
    342 Fair
  8. Nancy L. Geller
    65 Geller
  9. Michael J. Morse
    40 Morse