دورية أكاديمية
أعرض في EDS

Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours.

التفاصيل البيبلوغرافية
العنوان: Alternating dose-dense chemotherapy in patients with high volume disseminated non-seminomatous germ cell tumours.
المؤلفون: Fizazi K; Department of Genitourinary Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. fizazi@igr.fr, Prow DM, Do KA, Wang X, Finn L, Kim J, Daliani D, Papandreou CN, Tu SM, Millikan RE, Pagliaro LC, Logothetis CJ, Amato RJ
المصدر: British journal of cancer [Br J Cancer] 2002 May 20; Vol. 86 (10), pp. 1555-60.
نوع المنشور: Clinical Trial; Clinical Trial, Phase II; Journal Article
اللغة: English
بيانات الدورية: Publisher: Nature Publishing Group on behalf of Cancer Research UK Country of Publication: England NLM ID: 0370635 Publication Model: Print Cited Medium: Print ISSN: 0007-0920 (Print) Linking ISSN: 00070920 NLM ISO Abbreviation: Br J Cancer Subsets: MEDLINE
أسماء مطبوعة: Publication: 2002- : London : Nature Publishing Group on behalf of Cancer Research UK
Original Publication: London, Lewis.
مواضيع طبية MeSH: Antineoplastic Combined Chemotherapy Protocols/*therapeutic use , Germinoma/*drug therapy , Seminoma/*drug therapy , Testicular Neoplasms/*drug therapy, Adolescent ; Adult ; Anemia, Refractory, with Excess of Blasts/chemically induced ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Biomarkers, Tumor/blood ; Bleomycin/administration & dosage ; Bleomycin/adverse effects ; Cisplatin/administration & dosage ; Cisplatin/adverse effects ; Cyclophosphamide/administration & dosage ; Cyclophosphamide/adverse effects ; Dactinomycin/administration & dosage ; Dactinomycin/adverse effects ; Disease-Free Survival ; Doxorubicin/administration & dosage ; Doxorubicin/adverse effects ; Etoposide/administration & dosage ; Etoposide/adverse effects ; Gastrointestinal Diseases/chemically induced ; Germinoma/mortality ; Germinoma/pathology ; Germinoma/secondary ; Hematologic Diseases/chemically induced ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/secondary ; Male ; Methotrexate/administration & dosage ; Methotrexate/adverse effects ; Middle Aged ; Peripheral Nervous System Diseases/chemically induced ; Prognosis ; Prospective Studies ; Remission Induction ; Seminoma/mortality ; Seminoma/pathology ; Seminoma/secondary ; Survival Analysis ; Survival Rate ; Testicular Neoplasms/mortality ; Testicular Neoplasms/pathology ; Treatment Outcome ; Vincristine/administration & dosage ; Vincristine/adverse effects
مستخلص: Only about half of patients with a poor-prognosis non-seminomatous germ-cell tumours can achieve a cure. The aim of this phase II study was to assess the efficacy and toxicity of a dose-dense alternating chemotherapy regimen in this subset of patients. High volume non-seminomatous germ-cell tumours was defined as follows: at least two sites of non pulmonary metastases, an extragonadal primary tumour, a serum human chorionic gonadotropin level higher than 10 000 mIU x ml(-1), or a alpha-foetoprotein level higher than 2000 mIU ml(-1). Patients who fulfilled these criteria were treated with the so-called BOP-CISCA-POMB-ACE regimen (bleomycin, vincristine, and cisplatin; cisplatin, cyclophosphamide, and doxorubicin; cisplatin, vincristine, methotrexate, and bleomycin; etoposide, dactinomycin, and cyclophosphamide) plus granulocyte colony-stimulating factor. A total of 58 patients were enrolled. Patients were retrospectively classified according to the International Germ-Cell Cancer Consensus Group classification; 38 patients (66%) had poor-prognosis disease and 19 patients (33%) had intermediate-prognosis. Patients received a median of 2.5 courses (range 0.25 to five courses) of the BOP-CISCA-POMB-ACE regimen. Forty-two patients (72.4%) had a complete response to therapy. With a median follow-up time of 31 months, the 3-year progression-free survival rate was 71% (95% confidence interval, 60 to 84%) and the 3-year overall survival rate was 73% (95% confidence interval: 62 to 86%). The 3-year PFS rates were 83% (95% confidence interval: 68 to 100%) in the intermediate-prognosis group and 65% (95% confidence interval: 51 to 82%) in the poor-prognosis group. Early side effects included mainly grade 4 haematologic toxicity (neutropaenia in 79% of patients, thrombocytopaenia in 69%, anaemia in 22%), grade 4 stomatitis (19%), and four early deaths (7% of patients), at least partially related to toxicity. The dose-dense BOP-CISCA-POMB-ACE regimen is highly active in patients with non-seminomatous germ-cell tumours classified as intermediate-prognosis or poor-prognosis according to the International Germ-Cell Cancer Consensus Group. Because outcomes with this regimen compare favourably with outcome after standard therapy, dose-dense chemotherapy should be further investigated in this subset of patients.
(comCopyright 2002 Cancer Research UK)
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المشرفين على المادة: 0 (Biomarkers, Tumor)
11056-06-7 (Bleomycin)
1CC1JFE158 (Dactinomycin)
5J49Q6B70F (Vincristine)
6PLQ3CP4P3 (Etoposide)
80168379AG (Doxorubicin)
8N3DW7272P (Cyclophosphamide)
Q20Q21Q62J (Cisplatin)
YL5FZ2Y5U1 (Methotrexate)
SCR Protocol: BOP-CISCA-POMB-ACE regimen
تواريخ الأحداث: Date Created: 20020627 Date Completed: 20020802 Latest Revision: 20181113
رمز التحديث: 20240627
مُعرف محوري في PubMed: PMC2746595
DOI: 10.1038/sj.bjc.6600272
PMID: 12085204
قاعدة البيانات: MEDLINE
الوصف
تدمد:0007-0920
DOI:10.1038/sj.bjc.6600272