Modified cisplatin, etoposide (or vinblastine) and ifosfamide salvage therapy for male germ-cell tumors. Long-term results

G. Pizzocaro, R. Salvioni, L. Piva, M. Faustini, N. Nicolai, L. Gianni

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Abstract

Between 1985 and 1989, 36 consecutive male patients with advanced germ-cell tumors, who had failed to be cured with either the cisplatin, vinblastine, bleomycin (PVB) or the cisplatin, etoposide, bleomycin (PEB) combinations, entered either of two modified salvage therapy regimens consisting of cisplatin, etoposide, and ifosfamide (PEI) or cisplatin, vinblastine and ifosfamide (PVI). All patients had evidence of active disease. Ifosfamide was given at the dosage of 2.5 gr/m 2 (with mesna protection) on days 1 and 2; etoposide and cisplatin were given at the dosage of 100 mg/m 2 and 40 mg/m 2, respectively, on days 3 to 5. In the PVI schedule, vinblastine 6 mg/m 2 was given on day 3. Overall, 20 (56%, C.I. 39 to 72) patients entered complete response (CR) or achieved disease-free status (NED) with postchemotherapy surgery. After a follow-up of 2 to 7 years, 15 patients (42%, C.I. 24 to 58) remain alive and free of disease. None of the 9 patients unresponsive to the first-line therapy and/or with extragonadal primaries entered CR or achieved the NED status, versus 20 (74%, C.I. 58 to 91) of the 27 patients with primary testicular tumors who were responsive to the first-line therapy (p <0.001). PEI was used in 20 of these 27 patients, with excellent results (90% CR and 70% continuously NED) independently of primary therapy, PVB or PEB. By contrast, only 2 of the 7 patients treated with PVI following PEB entered CR. Toxicity was not life-threatening. Nine (25%) patients suffered granulocytopenic fever and 3 (8%) required platelet transfusions. Renal toxicity and hematuria were moderate, occurring in 2 patients each. Other toxic signs were as usual.

Original languageEnglish
Pages (from-to)211-216
Number of pages6
JournalAnnals of Oncology
Volume3
Issue number3
Publication statusPublished - 1992

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Salvage Therapy
Ifosfamide
Vinblastine
Etoposide
Cisplatin
Bleomycin
Male Germ Cell Tumor
Mesna
Platelet Transfusion
Germ Cell and Embryonal Neoplasms
Poisons
Testicular Neoplasms
Hematuria
Appointments and Schedules
Fever
Therapeutics
Kidney

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

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title = "Modified cisplatin, etoposide (or vinblastine) and ifosfamide salvage therapy for male germ-cell tumors. Long-term results",
abstract = "Between 1985 and 1989, 36 consecutive male patients with advanced germ-cell tumors, who had failed to be cured with either the cisplatin, vinblastine, bleomycin (PVB) or the cisplatin, etoposide, bleomycin (PEB) combinations, entered either of two modified salvage therapy regimens consisting of cisplatin, etoposide, and ifosfamide (PEI) or cisplatin, vinblastine and ifosfamide (PVI). All patients had evidence of active disease. Ifosfamide was given at the dosage of 2.5 gr/m 2 (with mesna protection) on days 1 and 2; etoposide and cisplatin were given at the dosage of 100 mg/m 2 and 40 mg/m 2, respectively, on days 3 to 5. In the PVI schedule, vinblastine 6 mg/m 2 was given on day 3. Overall, 20 (56{\%}, C.I. 39 to 72) patients entered complete response (CR) or achieved disease-free status (NED) with postchemotherapy surgery. After a follow-up of 2 to 7 years, 15 patients (42{\%}, C.I. 24 to 58) remain alive and free of disease. None of the 9 patients unresponsive to the first-line therapy and/or with extragonadal primaries entered CR or achieved the NED status, versus 20 (74{\%}, C.I. 58 to 91) of the 27 patients with primary testicular tumors who were responsive to the first-line therapy (p <0.001). PEI was used in 20 of these 27 patients, with excellent results (90{\%} CR and 70{\%} continuously NED) independently of primary therapy, PVB or PEB. By contrast, only 2 of the 7 patients treated with PVI following PEB entered CR. Toxicity was not life-threatening. Nine (25{\%}) patients suffered granulocytopenic fever and 3 (8{\%}) required platelet transfusions. Renal toxicity and hematuria were moderate, occurring in 2 patients each. Other toxic signs were as usual.",
author = "G. Pizzocaro and R. Salvioni and L. Piva and M. Faustini and N. Nicolai and L. Gianni",
year = "1992",
language = "English",
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T1 - Modified cisplatin, etoposide (or vinblastine) and ifosfamide salvage therapy for male germ-cell tumors. Long-term results

AU - Pizzocaro, G.

AU - Salvioni, R.

AU - Piva, L.

AU - Faustini, M.

AU - Nicolai, N.

AU - Gianni, L.

PY - 1992

Y1 - 1992

N2 - Between 1985 and 1989, 36 consecutive male patients with advanced germ-cell tumors, who had failed to be cured with either the cisplatin, vinblastine, bleomycin (PVB) or the cisplatin, etoposide, bleomycin (PEB) combinations, entered either of two modified salvage therapy regimens consisting of cisplatin, etoposide, and ifosfamide (PEI) or cisplatin, vinblastine and ifosfamide (PVI). All patients had evidence of active disease. Ifosfamide was given at the dosage of 2.5 gr/m 2 (with mesna protection) on days 1 and 2; etoposide and cisplatin were given at the dosage of 100 mg/m 2 and 40 mg/m 2, respectively, on days 3 to 5. In the PVI schedule, vinblastine 6 mg/m 2 was given on day 3. Overall, 20 (56%, C.I. 39 to 72) patients entered complete response (CR) or achieved disease-free status (NED) with postchemotherapy surgery. After a follow-up of 2 to 7 years, 15 patients (42%, C.I. 24 to 58) remain alive and free of disease. None of the 9 patients unresponsive to the first-line therapy and/or with extragonadal primaries entered CR or achieved the NED status, versus 20 (74%, C.I. 58 to 91) of the 27 patients with primary testicular tumors who were responsive to the first-line therapy (p <0.001). PEI was used in 20 of these 27 patients, with excellent results (90% CR and 70% continuously NED) independently of primary therapy, PVB or PEB. By contrast, only 2 of the 7 patients treated with PVI following PEB entered CR. Toxicity was not life-threatening. Nine (25%) patients suffered granulocytopenic fever and 3 (8%) required platelet transfusions. Renal toxicity and hematuria were moderate, occurring in 2 patients each. Other toxic signs were as usual.

AB - Between 1985 and 1989, 36 consecutive male patients with advanced germ-cell tumors, who had failed to be cured with either the cisplatin, vinblastine, bleomycin (PVB) or the cisplatin, etoposide, bleomycin (PEB) combinations, entered either of two modified salvage therapy regimens consisting of cisplatin, etoposide, and ifosfamide (PEI) or cisplatin, vinblastine and ifosfamide (PVI). All patients had evidence of active disease. Ifosfamide was given at the dosage of 2.5 gr/m 2 (with mesna protection) on days 1 and 2; etoposide and cisplatin were given at the dosage of 100 mg/m 2 and 40 mg/m 2, respectively, on days 3 to 5. In the PVI schedule, vinblastine 6 mg/m 2 was given on day 3. Overall, 20 (56%, C.I. 39 to 72) patients entered complete response (CR) or achieved disease-free status (NED) with postchemotherapy surgery. After a follow-up of 2 to 7 years, 15 patients (42%, C.I. 24 to 58) remain alive and free of disease. None of the 9 patients unresponsive to the first-line therapy and/or with extragonadal primaries entered CR or achieved the NED status, versus 20 (74%, C.I. 58 to 91) of the 27 patients with primary testicular tumors who were responsive to the first-line therapy (p <0.001). PEI was used in 20 of these 27 patients, with excellent results (90% CR and 70% continuously NED) independently of primary therapy, PVB or PEB. By contrast, only 2 of the 7 patients treated with PVI following PEB entered CR. Toxicity was not life-threatening. Nine (25%) patients suffered granulocytopenic fever and 3 (8%) required platelet transfusions. Renal toxicity and hematuria were moderate, occurring in 2 patients each. Other toxic signs were as usual.

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