High-dose chemotherapy as primary treatment for poor-risk germ-cell tumors: The Memorial Sloan-Kettering Experience (1988-1999) Journal Article
| Authors: | Morris, M. J.; Bosl, G. J. |
| Article Title: | High-dose chemotherapy as primary treatment for poor-risk germ-cell tumors: The Memorial Sloan-Kettering Experience (1988-1999) |
| Abstract: | Although the majority of patients with poor-risk germ-cell tumors (GCTs) will achieve a durable complete remission (CR) with standard first-line therapy, 20% to 30% of them will either relapse or fail to achieve an initial CR and eventually die. For this reason, the strategy of using high-dose (HD) chemotherapy with autologous stem-cell support has been investigated to improve the chances of cure attainable in the salvage setting, but at a cost of significant morbidity and mortality. Treatment using HD therapy in the first-line setting offers the promise of reducing morbidity and mortality while increasing efficacy. At Memorial Sloan-Kettering Cancer Center (MSKCC), trials were conducted to test this hypothesis. patients at: high risk of relapse following conventional therapy were identified, based on post-treatment serum marker concentrations that failed to appropriately decline by predicted half-life after several cycles of standard treatment, These patients received first-line HD treatment, Patients received a 2-drug HD regimen in one trial and an intensified 3-drug regimen in another, each with autologous bone marrow transplantation, These patients had improved overall and event-free survival rates (p = 0.001 and 0.003, respectively) compared with historical controls who underwent standard First-line treatment, with a tower incidence of treatment-related mortality than patients who received HD therapy in the salvage setting, Randomized trials are under way to prospectively verify these results. (C) 1999 Wiley-Liss, inc. |
| Keywords: | cisplatin; carboplatin; etoposide; ifosfamide; trial; southwest-oncology-group; bone-marrow transplantation; salvage chemotherapy; cancer-center experience; marker half-life |
| Journal Title: | International Journal of Cancer |
| Volume: | 83 |
| Issue: | 6 |
| ISSN: | 0020-7136 |
| Publisher: | John Wiley & Sons |
| Date Published: | 1999-12-10 |
| Start Page: | 834 |
| End Page: | 838 |
| Language: | English |
| ACCESSION: | WOS:000083939100026 |
| DOI: | 10.1002/(sici)1097-0215(19991210)83:6<834::aid-ijc25>3.0.co;2-i |
| PROVIDER: | wos |
| PUBMED: | 10597205 |
| Notes: | Article -- Source: Wos |
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