Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2005-11-8
pubmed:abstractText
We evaluated the antitumor activity of tandem cycles of high-dose chemotherapy with autologous peripheral stem cell transplantation (aPSCT) in relapsed germ cell tumors by using high-dose paclitaxel, carboplatin, etoposide, and ifosfamide. Thirty-three patients were entered, and 31 underwent protocol therapy. Paclitaxel 350 mg/m2 (5 patients) or 425 mg/m2 (26 patients) by 24-hour continuous intravenous infusion was followed by 3 daily doses of carboplatin and either etoposide (cycle 1) or ifosfamide/mesna (cycle 2). The carboplatin dose had a calculated area under the curve of 7 mg-min/mL, and the daily dose of etoposide was 20 mg/kg (cycle 1). Ifosfamide 3 g/m2/d for 3 days (with mesna uroprotection) was substituted for etoposide in cycle 2. Each cycle was supported by granulocyte colony-stimulating factor-mobilized peripheral blood stem cells. Thirty-one patients were evaluable for response, toxicity, and long-term disease control. Two patients did not undergo aPSCT because of rapid disease progression. Nineteen patients received both cycles of aPSCT, 8 progressed after cycle 1, 3 refused the second cycle, and 1 died of fungal infection during cycle 1. Twelve patients remain relapse free at a median of 67 months from the initiation of therapy. Whereas the International Germ Cell Cancer Collaborative Group category at the time of initial diagnosis did not seem to predict outcome, the patient's probability of achieving durable remission was significantly associated with the Beyer prognostic score at the time of protocol entry. Regimens containing the most active agents in relapsed nonseminomatous germ cell tumors, including high-dose paclitaxel, are well tolerated and have promising activity even in patients with poor-risk features who do not achieve durable remissions with standard therapy. The Beyer prognostic system is a valuable predictor for patients undergoing aPSCT.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1083-8791
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
903-11
pubmed:dateRevised
2007-11-14
pubmed:meshHeading
pubmed-meshheading:16275593-Adolescent, pubmed-meshheading:16275593-Adult, pubmed-meshheading:16275593-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:16275593-Carboplatin, pubmed-meshheading:16275593-Etoposide, pubmed-meshheading:16275593-Female, pubmed-meshheading:16275593-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:16275593-Humans, pubmed-meshheading:16275593-Ifosfamide, pubmed-meshheading:16275593-Male, pubmed-meshheading:16275593-Middle Aged, pubmed-meshheading:16275593-Neoplasms, Germ Cell and Embryonal, pubmed-meshheading:16275593-Paclitaxel, pubmed-meshheading:16275593-Peripheral Blood Stem Cell Transplantation, pubmed-meshheading:16275593-Prognosis, pubmed-meshheading:16275593-Salvage Therapy, pubmed-meshheading:16275593-Survival Analysis, pubmed-meshheading:16275593-Transplantation, Autologous, pubmed-meshheading:16275593-Treatment Outcome
pubmed:year
2005
pubmed:articleTitle
Paclitaxel-based high-dose chemotherapy with autologous stem cell rescue for relapsed germ cell cancer.
pubmed:affiliation
Department of Medical Oncology, City of Hope National Medical Center, Duarte, California 91010, USA. kmargolin@coh.org
pubmed:publicationType
Journal Article, Clinical Trial, Research Support, N.I.H., Extramural