PURPOSE: To compare the efficacy of four cycles of paclitaxel-bleomycin, etoposide, and cisplatin (T-BEP) to four cycles of bleomycin, etoposide, and cisplatin (BEP) in previously untreated patients with intermediate-prognosis germ-cell cancer (GCC). PATIENTS AND METHODS: Patients were randomly assigned to receive either T-BEP or standard BEP. Patients assigned to the T-BEP group received paclitaxel 175 mg/m(2) in a 3-hour infusion. Patients who were administered T-BEP received primary granulocyte colony-stimulating factor (G-CSF) prophylaxis. The study was designed as a randomized open-label phase II/III study. To show a 10% improvement in 3-year progression-free survival (PFS), the study aimed to recruit 498 patients but closed with 337 patients as a result of slow accrual. RESULTS: Accrual was from November 1998 to April 2009. A total of 169 patients were administered BEP, and 168 patients were administered T-BEP. Thirteen patients in both arms were ineligible, mainly as a result of a good prognosis of GCC (eight patients administered BEP; six patients administered T-BEP) or a poor prognosis of GCC (one patient administered BEP; four patients administered T-BEP). PFS at 3 years (intent to treat) was 79.4% in the T-BEP group versus 71.1% in the BEP group (hazard ratio [HR], 0.73; CI, 0.47 to 1.13; P [log-rank test] = 0.153). PFS at 3 years in all eligible patients was 82.7% versus 70.1%, respectively (HR, 0.60; CI: 0.37 to 0.97) and was statistically significant (P = 0.03). Overall survival was not statistically different. CONCLUSION: T-BEP administered with G-CSF seems to be a safe and effective treatment regimen for patients with intermediate-prognosis GCC. However, the study recruited a smaller-than-planned number of patients and included 7.7% ineligible patients. The primary analysis of the trial could not demonstrate statistical superiority of T-BEP for PFS. When ineligible patients were excluded, the analysis of all eligible patients demonstrated a 12% superior 3-year PFS with T-BEP, which was statistically significant.
PURPOSE: To compare the efficacy of four cycles of paclitaxel-bleomycin, etoposide, and cisplatin (T-BEP) to four cycles of bleomycin, etoposide, and cisplatin (BEP) in previously untreated patients with intermediate-prognosis germ-cell cancer (GCC). PATIENTS AND METHODS: Patients were randomly assigned to receive either T-BEP or standard BEP. Patients assigned to the T-BEP group received paclitaxel 175 mg/m(2) in a 3-hour infusion. Patients who were administered T-BEP received primary granulocyte colony-stimulating factor (G-CSF) prophylaxis. The study was designed as a randomized open-label phase II/III study. To show a 10% improvement in 3-year progression-free survival (PFS), the study aimed to recruit 498 patients but closed with 337 patients as a result of slow accrual. RESULTS: Accrual was from November 1998 to April 2009. A total of 169 patients were administered BEP, and 168 patients were administered T-BEP. Thirteen patients in both arms were ineligible, mainly as a result of a good prognosis of GCC (eight patients administered BEP; six patients administered T-BEP) or a poor prognosis of GCC (one patient administered BEP; four patients administered T-BEP). PFS at 3 years (intent to treat) was 79.4% in the T-BEP group versus 71.1% in the BEP group (hazard ratio [HR], 0.73; CI, 0.47 to 1.13; P [log-rank test] = 0.153). PFS at 3 years in all eligible patients was 82.7% versus 70.1%, respectively (HR, 0.60; CI: 0.37 to 0.97) and was statistically significant (P = 0.03). Overall survival was not statistically different. CONCLUSION: T-BEP administered with G-CSF seems to be a safe and effective treatment regimen for patients with intermediate-prognosis GCC. However, the study recruited a smaller-than-planned number of patients and included 7.7% ineligible patients. The primary analysis of the trial could not demonstrate statistical superiority of T-BEP for PFS. When ineligible patients were excluded, the analysis of all eligible patients demonstrated a 12% superior 3-year PFS with T-BEP, which was statistically significant.
Authors: G Daugaard; I Skoneczna; N Aass; R De Wit; M De Santis; H Dumez; S Marreaud; L Collette; J R G Lluch; C Bokemeyer; H J Schmoll Journal: Ann Oncol Date: 2010-11-08 Impact factor: 32.976
Authors: C Bokemeyer; J Beyer; B Metzner; U Ruther; A Harstrick; L Weissbach; U Kohrmann; W Verbeek; H J Schmoll Journal: Ann Oncol Date: 1996-01 Impact factor: 32.976
Authors: Robert J Motzer; Craig J Nichols; Kim A Margolin; Jennifer Bacik; Paul G Richardson; Nicholas J Vogelzang; Dean F Bajorin; Primo N Lara; Lawrence Einhorn; Madhu Mazumdar; George J Bosl Journal: J Clin Oncol Date: 2007-01-20 Impact factor: 44.544
Authors: R J Motzer; D F Bajorin; L H Schwartz; H S Hutter; G J Bosl; H I Scher; P Lyn; P Fischer Journal: J Clin Oncol Date: 1994-11 Impact factor: 44.544
Authors: Martha W den Hollander; Nico-Derk L Westerink; Sjoukje Lubberts; Alfons H H Bongaerts; Rienhart F E Wolf; Renska Altena; Janine Nuver; Sjoukje F Oosting; Elisabeth G E de Vries; Anna M E Walenkamp; Coby Meijer; Jourik A Gietema Journal: Oncologist Date: 2016-06-21
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: Darren R Feldman; James Hu; Tanya B Dorff; Kristina Lim; Sujata Patil; Kaitlin M Woo; Maryann Carousso; Amanda Hughes; Joel Sheinfeld; Manjit Bains; Siamak Daneshmand; Charlene Ketchens; Dean F Bajorin; George J Bosl; David I Quinn; Robert J Motzer Journal: J Clin Oncol Date: 2016-05-16 Impact factor: 44.544