Combination chemotherapy with gemcitabine, oxaliplatin, and paclitaxel in patients with cisplatin-refractory or multiply relapsed germ-cell tumors: a study of the German Testicular Cancer Study Group.

Abstract

BACKGROUND:

The aim of this study is to determine feasibility and efficacy of the combination regimen gemcitabine, oxaliplatin, and paclitaxel (GOP) in patients with cisplatin-refractory or multiply relapsed germ-cell tumors.

PATIENTS AND METHODS:

From April 2003 to October 2006, 41 patients refractory to cisplatin-based chemotherapy or with relapse after high-dose chemotherapy (HDCT) plus stem-cell support (peripheral blood stem-cell transplantation: PBSCT) received 800 mg/m2 gemcitabine, 80 mg/m2 paclitaxel (Taxol), both on days 1 + 8, and oxaliplatin 130 mg/m2 on day 1 of a 3-week cycle for a minimum of two cycles. Primary end point was response rate. Patients were pretreated with a median of two lines of platin-based chemotherapy (range, 1-3), and 78% had relapsed after HDCT/PBSCT.

RESULTS:

Seventy-three percent of patients had relapsed within 3 months after the last cisplatin-based chemotherapy. Five percent of the patients achieved a complete response, and 34% and 12% a marker-negative and marker-positive partial response, respectively (overall response rate 51%). After a median follow-up of 5 months (range, 0-20), 15% of the patients remain in complete remission after GOP chemotherapy +/- residual tumor resection with a median response duration of 8 months (1 to 17+). Main toxicity was leucocytopenia grade 3/4 in 15%, anemia in 7%, and thrombocytopenia in 49% of the patients.

CONCLUSION:

Combination chemotherapy with GOP is feasible and effective with acceptable toxicity in patients with treatment-refractory germ-cell tumors.

• Authors: C Bokemeyer, K Oechsle, F Honecker, F Mayer, J T Hartmann, C F Waller, I Böhlke, C Kollmannsberger, German Testicular Cancer Study Group
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 19 Issue 3 Pg. 448-53 (Mar 2008) ISSN: 1569-8041 [Electronic] England
• PMID: 18006893 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Organoplatinum Compounds
• Oxaliplatin
• Deoxycytidine
• Paclitaxel
• Gemcitabine

Topics

• Adult
• Anemia (chemically induced)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Drug Resistance, Neoplasm
• Feasibility Studies
• Humans
• Leukopenia (chemically induced)
• Male
• Middle Aged
• Neoplasm Staging
• Neoplasms, Germ Cell and Embryonal (drug therapy, pathology, secondary)
• Organoplatinum Compounds (administration & dosage)
• Oxaliplatin
• Paclitaxel (administration & dosage)
• Testicular Neoplasms (drug therapy, pathology)
• Thrombocytopenia (chemically induced)
• Treatment Outcome
• Gemcitabine