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Paclitaxel-containing high-dose chemotherapy for relapsed or refractory testicular germ cell tumours

British Journal of Cancer, ISSN: 0007-0920, Vol: 90, Issue: 6, Page: 1169-1175
2004
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Article Description

High-dose regimes containing etoposide, carboplatin and an oxazaphospharine can salvage 30-40% of patients with relapsed or refractory male germ cell tumours (GCTs). The additional benefit of paclitaxel in such high-dose therapy has not been tested. Between March 1995 and November 2002, 36 male GCT patients were treated with Carbop-EC-T (paclitaxel 75 mg m, etoposide 450 mg m, carboplatin AUC 10 on days -7, -5 and -3 and cyclophosphamide 60 mg kg on days -5 and -3) followed by peripheral blood stem cell infusion (day 0). The 1-year overall survival rate for all patients is 67% (median follow-up 29 months). For the 24 patients with cisplatin-sensitive disease, the 1-year overall and event-free survivals are 88 and 64%, respectively. For those with cisplatin refractory or absolutely refractory disease, the 1-year overall survival is 25%. In all, 12 patients relapsed at a median duration of 5 months, 11 of whom have died. There were also six treatment-related deaths, five associated with pneumonitis. Pulmonary toxicity has been reported with paclitaxel in other high-dose regimes. Since altering our protocol so that paclitaxel is infused over 24 h with steroid prophylaxis, only one of 18 patients (13 testicular GCTs and five other tumour types) has had a treatment-related death. Our results suggest that Carbop-EC-T may enable a greater proportion of patients with relapsed and refractory GCTs to enter long-term remission. © 2004 Cancer Research UK.

Bibliographic Details

I. A. McNeish; R. Haynes; E. S. Newlands; M. J. Seckl; E. J. Kanfer; C. Giles; S. J. Harland; D. Driver; G. J.S. Rustin

Springer Science and Business Media LLC

Medicine; Biochemistry, Genetics and Molecular Biology

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