BACKGROUND: Chemotherapy including gemcitabine, oxaliplatin, and/or paclitaxel has shown efficacy in germ cell tumor patients after progression during cisplatin-based chemotherapy or relapse after high-dose chemotherapy including complete responses in 5-15%. OBJECTIVE: Most studies have been published with a short follow-up. We present the long-term outcome of two previously reported trials. DESIGN, SETTING, AND PARTICIPANTS: Two phase 2 trials have evaluated chemotherapy with gemcitabine plus oxaliplatin alone (GO) or plus paclitaxel (GOP) including a total of 76 patients (35 GO and 41 GOP). At first publication, 29 patients were still alive and 9 patients (12%) were free of disease after chemotherapy with or without surgery: GO, 3 of 35 (9%) and GOP, 6 of 41 (15%). MEASUREMENTS: Survival and follow-up time were calculated using the Kaplan-Meier method from the beginning of study treatment until the date of death or the date of the last follow-up. RESULTS AND LIMITATIONS: After a median follow-up of 19 mo (2-86 mo) for the 29 patients still alive, 11% of all patients (8 of 76) were free of disease for >2 yr: 1 of 35 patients (3%) after GO and 7 of 41 patients (17%) after GOP. Three patients with complete remission (CR), two after GO and one after GOP, relapsed. Two others treated with GOP were rendered disease free: One patient with partial remission and short follow-up underwent secondary surgery, and another patient, who had relapsed 2 mo after GOP, achieved a CR after salvage treatment. Overall survival time is ≥33 mo (range: ≥ 28-59 mo) in these eight patients. CONCLUSIONS: Long-term survival can be achieved in about 10-15% of patients with cisplatin-refractory or multiply relapsed germ cell tumor with GO(P) chemotherapy. Aggressive secondary surgery following partial remission is a crucial part of this salvage treatment.
BACKGROUND: Chemotherapy including gemcitabine, oxaliplatin, and/or paclitaxel has shown efficacy in germ cell tumorpatients after progression during cisplatin-based chemotherapy or relapse after high-dose chemotherapy including complete responses in 5-15%. OBJECTIVE: Most studies have been published with a short follow-up. We present the long-term outcome of two previously reported trials. DESIGN, SETTING, AND PARTICIPANTS: Two phase 2 trials have evaluated chemotherapy with gemcitabine plus oxaliplatin alone (GO) or plus paclitaxel (GOP) including a total of 76 patients (35 GO and 41 GOP). At first publication, 29 patients were still alive and 9 patients (12%) were free of disease after chemotherapy with or without surgery: GO, 3 of 35 (9%) and GOP, 6 of 41 (15%). MEASUREMENTS: Survival and follow-up time were calculated using the Kaplan-Meier method from the beginning of study treatment until the date of death or the date of the last follow-up. RESULTS AND LIMITATIONS: After a median follow-up of 19 mo (2-86 mo) for the 29 patients still alive, 11% of all patients (8 of 76) were free of disease for >2 yr: 1 of 35 patients (3%) after GO and 7 of 41 patients (17%) after GOP. Three patients with complete remission (CR), two after GO and one after GOP, relapsed. Two others treated with GOP were rendered disease free: One patient with partial remission and short follow-up underwent secondary surgery, and another patient, who had relapsed 2 mo after GOP, achieved a CR after salvage treatment. Overall survival time is ≥33 mo (range: ≥ 28-59 mo) in these eight patients. CONCLUSIONS: Long-term survival can be achieved in about 10-15% of patients with cisplatin-refractory or multiply relapsed germ cell tumor with GO(P) chemotherapy. Aggressive secondary surgery following partial remission is a crucial part of this salvage treatment.
Authors: Anupam Batra; Scott Ernst; Kylea Potvin; Ricardo Fernandes; Nicholas Power; James Vanhie; Eric Winquist Journal: Can Urol Assoc J Date: 2019-07-23 Impact factor: 1.862
Authors: Christoph Oing; Winfried H Alsdorf; Gunhild von Amsberg; Karin Oechsle; Carsten Bokemeyer Journal: World J Urol Date: 2016-07-23 Impact factor: 4.226
Authors: Kenneth S Chen; Nicholas J Fustino; Abhay A Shukla; Emily K Stroup; Albert Budhipramono; Christina Ateek; Sarai H Stuart; Kiyoshi Yamaguchi; Payal Kapur; A Lindsay Frazier; Lawrence Lum; Leendert H J Looijenga; Theodore W Laetsch; Dinesh Rakheja; James F Amatruda Journal: Mol Cancer Ther Date: 2018-02-26 Impact factor: 6.261