Switch to
Predicate | Object |
---|---|
rdf:type | |
lifeskim:mentions |
umls-concept:C0005740,
umls-concept:C0015133,
umls-concept:C0030705,
umls-concept:C0032854,
umls-concept:C0033325,
umls-concept:C0079083,
umls-concept:C0079460,
umls-concept:C0178602,
umls-concept:C0183683,
umls-concept:C0344211,
umls-concept:C1171411,
umls-concept:C1266158,
umls-concept:C1317973,
umls-concept:C1519043,
umls-concept:C1521721,
umls-concept:C1521750,
umls-concept:C1561558
|
pubmed:issue |
5
|
pubmed:dateCreated |
1997-2-3
|
pubmed:abstractText |
To determine the maximum tolerated dose (MTD), and therapeutic efficacy of carboplatin (CBDCA) in combination with etoposide and bleomycin (CEB) as initial chemotherapy for poor prognosis germ cell tumors, a CBDCA dose escalation supported with GM-CSF had been performed. Twenty four untreated patients were treated with CBDCA 400 mg/m2 on day 1, etoposide 100 mg/m2 on days 1 to 5 and bleomycin 30 mg on days 1, 3, 5. Four cycles were scheduled at 21-day interval. The first cohort of 6 patients received only initial chemotherapy regimen. In the subsequent cohorts of six patients, the CBDCA dose was increased by 100 mg/m2. A fixed dose and schedule of GM-CSF at 5 micrograms/kg subcutaneously was given on days 6 through 15. Myelosuppression, with neutropenic fever and hemorrhages, was the dose-limiting toxicity at the 600 mg/m2 dose level. The recommended dose of CBDCA is 500 mg/m2. Overall complete response (CR) rate was 71% and with median follow up of 25 (16-34) months, 58% of patients are alive and have no evidence of disease (NED). A higher number of CR was achieved with CBDCA dose higher than 400 mg/m2 compared with CBDCA dose of 400 mg/m2 (92 vs. 50%, p = 0.03), as well as a higher proportion of patients who are alive and with NED (75 vs. 42%, p = 0.1). Despite GM-CSF support, the MTD of CBDCA could not be increased beyond 500 mg/m2 (50% of the dose escalation), due to severe myelosuppression. The treatment outcomes obtained with CEB in our study are no better than the standard cisplatin-based chemotherapy. Further studies of this regimen, where CBDCA dose should be calculated according to the patients glomerular filtration rate are warranted.
|
pubmed:language |
eng
|
pubmed:journal | |
pubmed:citationSubset |
IM
|
pubmed:chemical | |
pubmed:status |
MEDLINE
|
pubmed:issn |
0028-2685
|
pubmed:author | |
pubmed:issnType |
Print
|
pubmed:volume |
43
|
pubmed:owner |
NLM
|
pubmed:authorsComplete |
Y
|
pubmed:pagination |
347-52
|
pubmed:dateRevised |
2006-11-15
|
pubmed:meshHeading |
pubmed-meshheading:8996556-Adult,
pubmed-meshheading:8996556-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:8996556-Bleomycin,
pubmed-meshheading:8996556-Carboplatin,
pubmed-meshheading:8996556-Etoposide,
pubmed-meshheading:8996556-Germinoma,
pubmed-meshheading:8996556-Granulocyte-Macrophage Colony-Stimulating Factor,
pubmed-meshheading:8996556-Humans,
pubmed-meshheading:8996556-Neutropenia,
pubmed-meshheading:8996556-Prognosis
|
pubmed:year |
1996
|
pubmed:articleTitle |
Phase I/II trial of carboplatin dose escalation in combination chemotherapy with etoposide, bleomycin and GM-CSF support for poor prognosis nonseminomatous germ cell tumors patients.
|
pubmed:affiliation |
Department of Clinical Pharmacology and Chemotherapy, Cancer Research Center, Moscow, Russia.
|
pubmed:publicationType |
Journal Article,
Clinical Trial,
Research Support, Non-U.S. Gov't,
Clinical Trial, Phase II,
Clinical Trial, Phase I
|