Authors: M. Foldyna; J. Abrahámová; J. Nepomucká; D. Kordíková Authors‘ workplace: Přednosta: Prof. MUDr. Jitka Abrahámová, DrSc. ; Onkologické oddělení Fakultní Thomayerovy nemocnice, Praha Published in: Prakt. Lék. 2008; 88(1): 36-38 Category: Of different specialties
Roughly 20% of patients with advanced GCT relapse or fail to achieve a complete response to conventional cis-platin based chemotherapy. Patients (pts) with relapsed or refractory GCT may be cured by salvage chemotherapy with gemcitabine and paclitaxel. 38 consecutive pts were treated with gemcitabine and paclitaxel at Thomayer Teaching Hospital in Prague from 1999 to June 2007. Highly pre-treated patients were treated with paclitaxel 175 mg/m² D1 and gemcitabine 1 000 mg/m² D1+5, int. 3-4w. Toxicity was quite low, haematological toxicity was manageable with growth factors and replacement of platelets. 12 pts attained CR, 6 pts PR, 11 patients had stable disease, progressive disease was observed in 9 pts. Median OS (overall survival) was 26 months. Median TTP (time to progression) was 16 months.
Conclusion: Salvage chemotherapy with paclitaxel and gemcitabine is an effective treatment with acceptable toxicity in highly pre-treated patients with recurrent germ-cell tumours.
Key words: salvage chemotherapy, germ cell tumours, gemcitabine, paclitaxel.
1. Abrahámová, J. Nádory varlat. Postgraduální medicína, 2003, 5, 6, s. 2-18.
2. 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, p. 599-605.
3. El-Helw, L., Coleman, R.E. Salvage, dose intense and high-dose chemotherapy for the treatment of poor prognosis or recurrent germ cell tumours. Cancer Treat. Rev. 2005, 31 (3): p. 197-209.
4.Foldyna, M., Abrahámová, J., Nepomucká, J. et al. Salvage chemotherapy with Paclitaxel and Gemcitabine In Patients with Reccurent Germ Cell Tumors (GCT). European Urology Meetings 2006, 1, 1, A 62.
5. Giorgi, U., Rosti, G., Aieta, M. et al. Phase II study oxaliplatin a gemcitabine salvage chemotherapy in patients with cisplatin refraktory non-seminomatous germ cell tumor. Eur. Urol. 2006, 50 (5), p. 1032-1038.
6. Hinton, S., Catalano, P., Einhorn, L. H. et al. Phase II study of paclitaxel plus gemcitabine in refractory germ cell tumors(E 9897). A trial of Eastern Cooperative Oncology Group. J. Clin. Oncol. 2002, 20, p. 1859-1863.
7. Kollmannsberg, C., Beyer, J., Liersch, R. et al. Combination chemotherapy with gemcitabine plus oxaliplatin in patients with intensively or refractory germ cell cancer. A study of the German Testicular Cancer Study Group. J. Clin. Oncol. 2004, 22, p. 108-114.
8. Kollmannsberger C., Nichols, C., Bokemeyer, C. Recent advances in management of patients with platinum-refractory testicular germ cell tumors. Cancer 2006; 106 (6): p. 1217-1726.
9. Pestacides, D., Pestacides, M., Farmakis, D. et al. Oxaliplatine and irinotecan plus granulocyte –colony stimulating factor as third-line treatment in relapsed or cisplatin-refractory germ-cell tumors patients. A phase II study. Eur. Urol. 2004, 46, p. 216-221.
10. Shamash, J., Powles, T., Mutsvangwa, K. et al. A phase II study using a topoisomerase I-based approach in patients with multiply relapsed germ-cell tumours. Ann. Oncol. 2007; 18 (5): p. 925-930.
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