Abstract
Background
Approximately 20% of patients with germ cell tumours do not respond fully to standard therapy, or relapse after treatment. The prognosis of these patients is poor with conventional chemotherapy. Preliminary data suggest that they may have a higher durable response rate with high dose chemotherapy and peripheral blood stem cell support.
Aims
To treat a group of testicular cancer patients, either with relapsed disease or with poor prognostic features initially, with high dose chemotherapy and stem cell support, and evaluate their outcome.
Methods
Five patients with testicular cancer were treated with high dose chemotherapy and stem cell support. Of these, four underwent this treatment as salvage therapy and one patient with poor prognostic features was treated as primary treatment.
Results
At an average follow-up of 18 months, four patients remain free of disease while one patient has developed relapse.
Conclusion
This report provides further support for high dose chemotherapy in this setting although randomised, controlled trials are essential to clarify its use.
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References
Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer Statistics 2000.CA Cancer J Clin 2000; 50 (1): 7–33.
IGCCCG. International Germ Cell Consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers.J Clin Oncol 1997; 15 (2): 594–603.
Motzer RJ, Mazumdar M, Gulati SC et al. Phase II trial of high dose carboplatin and etoposide with autologous bone marrow transplantation in first-line therapy for patients with poor risk germ cell tumours.J Natl Cancer Inst 1993; 85 (22): 1828–35.
Motzer RJ, Mazumdar M, Bajorin DF et al. High dose carboplatin, etoposide and cyclophosphamide with autologous bone marrow transplantation in first-line therapy for patients with poor risk germ cell tumours.J Clin Oncol 1997; 15 (7): 2546–52.
Motzer RJ, Mazumdar M, Sheinfeld J et al. Sequential dose-intensive paclitaxel, ifosfamide, carboplatin, and etoposide salvage therapy for germ cell tumor patients.J Clin Oncol 2000; 18 (6): 1173–80.
Bokemeyer C, Kollmannsberger C, Meisner C et al. First-line high dose chemotherapy compared with standard-dose PEB/VIP chemotherapy in patients with advanced germ cell tumors: a multivariate and matched-pair analysis.J Clin Oncol 1999; 17 (11): 3450–6.
Rick O, Bokemeyer C, Beyer J et al. Salvage treatment with paclitaxel, ifosfamide, and cisplatin plus high dose carboplatin, etoposide, and thiotepa followed by autologous stem cell rescue in patients with relapsed or refractory germ cellcancer.J Clin Oncol 2001; 19 (1): 81–8.
Bokemeyer C, Kollmannsberger C, Oechsle K et al. Early prediction of treatment response to high dose salvage chemotherapy in patients with relapsed germ cell cancer using [(18)F] FDG PET.Br J Cancer 2002; 86 (4): 506–11.
Chevreau C, Droz JP, Pico JL et al. Early intensified chemotherapy with autologous bone marrow transplantation in first line treatment of poor risk non-seminomatous germ cell tumours. Preliminary results of a French randomised trial.Eur Urol 1993; 23 (1): 213–8.
Beyer J, Stenning S, Gerl A et al. High dose versus conventional-dose chemotherapy as first-salvage treatment in patients with non-seminomatous germ cell tumors: a matched-pair analysis.Ann Oncol 2002; 13: 599–605.
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Hennessy, B., McCaffrey, J.A., Daly, P. et al. High dose chemotherapy and stem cell support for poor risk and recurrent nonseminomatous germ cell cancer: initial experience with sequential therapy. Ir J Med Sci 171, 158–160 (2002). https://doi.org/10.1007/BF03170506
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DOI: https://doi.org/10.1007/BF03170506