Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors Journal Article

Authors: Kondagunta, G. V.; Bacik, J.; Donadio, A.; Bajorin, D.; Marion, S.; Sheinfeld, J.; Bosl, G. J.; Motzer, R. J.
Article Title: Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors
Abstract: Purpose: The efficacy of paclitaxel was evaluated in combination with ifosfamide and cisplatin as second-line chemotherapy for patients with relapsed testicular germ cell tumors (GCTs). Patients and Methods: Forty-six patients with progressive metastatic GCTs were treated with paclitaxel and ifosfamide plus cisplatin (TIP) as second-line therapy. Eligibility required that patients have both a testis primary tumor site and a prior complete response (CR) to a first-line chemotherapy program, which had been identified previously as favorable prognostic factors to conventional-dose salvage chemotherapy. Results: Thirty-two (70%) of 46 patients achieved a CR to treatment. Three patients (7%) who achieved a CR relapsed after TIP chemotherapy. Twenty-nine patients are continuously disease free at a median follow-up time of 69 months, resulting in a 63% durable CR rate and a 2-year progression-free survival rate of 65% (95% CI, 51% to 79%). Conclusion: Four cycles of TIP as second-line therapy achieved a durable CR rate in a high proportion of patients with relapsed testicular GCT. The high CR rate emphasizes the importance of patient selection according to prognostic factors to achieve a favorable outcome to conventional-dose salvage therapy. © 2005 by American Society of Clinical Oncology.
Keywords: survival; adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; middle aged; survival analysis; major clinical study; clinical trial; mortality; neutropenia; cancer localization; salvage therapy; cisplatin; dose response; drug efficacy; patient selection; paclitaxel; neurotoxicity; follow up; antineoplastic agent; prospective study; prospective studies; carboplatin; liver toxicity; nephrotoxicity; neoplasm recurrence, local; bone marrow suppression; etoposide; antineoplastic combined chemotherapy protocols; drug administration schedule; cyclophosphamide; dexamethasone; continuous infusion; in vitro study; pathology; dose-response relationship, drug; ifosfamide; vinblastine; febrile neutropenia; confidence interval; confidence intervals; acute kidney failure; probability; tumor recurrence; testis tumor; testicular neoplasms; dactinomycin; bleomycin; maximum tolerated dose; drug administration; mesna; germ cell tumor; granulocyte colony stimulating factor; diphenhydramine; cimetidine; germinoma
Journal Title: Journal of Clinical Oncology
Volume: 23
Issue: 27
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2005-09-20
Start Page: 6549
End Page: 6555
Language: English
DOI: 10.1200/jco.2005.19.638
PUBMED: 16170162
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 107" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Dean Bajorin
    603 Bajorin
  2. Robert Motzer
    1079 Motzer
  3. Joel Sheinfeld
    241 Sheinfeld
  4. George Bosl
    421 Bosl
  5. Jennifer M Bacik
    46 Bacik
  6. Stephanie Marion
    8 Marion