Carboplatin AUC 10 for IGCCCG good prognosis metastatic seminoma.

Abstract

OBJECTIVE:

Metastatic seminoma is a highly curable disease. Standard treatment comprises of combination chemotherapy. The short- and long-term toxicities of this treatment are increasingly recognised and the possibility of over treatment in such a curable disease should be considered. We have therefore assessed the use of single agent carboplatin at a dose of AUC 10 in patients with good prognosis metastatic seminoma.

MATERIALS AND METHODS:

Patients with good prognosis metastatic seminoma treated with carboplatin (AUC 10) were identified at our institution and affiliated institutions. Treatment was three weekly for a total of three or four cycles. Outcome and toxicities were analysed.

RESULTS:

With a median follow-up of 36 months, 61 patients in total were treated with carboplatin AUC 10, all good prognosis by the IGCCCG criteria. Forty-eight percent had stage IIA/IIB disease and 52% had greater than stage IIB disease. Thirty-one patients (51%) had a complete response following treatment. Three-year survival was 96.3% with a three-year progression free survival of 93.2%. The main treatment toxicity was haematological with 46% having grade 3, 24% having grade 4 neutropenia and 54% experiencing grade 3/4 thrombocytopenia. There were no treatment related deaths.

CONCLUSION:

Single agent carboplatin at a dose of AUC 10 is an effective treatment for good prognosis metastatic seminoma. The outcome compares favourably to previously published outcomes of combination chemotherapy. Although haematological toxicity is a concern, single agent carboplatin treatment for good prognosis metastatic seminoma could be considered a treatment option and is associated with less toxicity than combination regimens currently used.

• Authors: Laura Tookman, Sukaina Rashid, Athena Matakidou, Melissa Phillips, Peter Wilson, Wendy Ansell, Mariam Jamal-Hanjani, Simon Chowdhury, Stephen Harland, Naveed Sarwar, Timothy Oliver, Thomas Powles, Jonathan Shamash
• Journal: Acta oncologica (Stockholm, Sweden) (Acta Oncol) Vol. 52 Issue 5 Pg. 987-93 (Jun 2013) ISSN: 1651-226X [Electronic] England
• PMID: 22943385 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents
• Carboplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Carboplatin (therapeutic use)
• Disease-Free Survival
• Dose-Response Relationship, Drug
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Neutropenia (chemically induced)
• Retrospective Studies
• Seminoma (drug therapy, pathology)
• Testicular Neoplasms (drug therapy, pathology)
• Thrombocytopenia (chemically induced)
• Treatment Outcome
• Young Adult