Salvage chemotherapy with paclitaxel and gemcitabine plus nedaplatin (TGN) as part of multidisciplinary therapy in patients with heavily pretreated cisplatin-refractory germ cell tumors
| Autor: | Kazuya Mikami, Terukazu Nakamura, Akihiro Kawauchi, Takumi Shiraishi, Natsuki Takaha, Tsuneharu Miki |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Oncology medicine.medical_specialty Lung Neoplasms Time Factors Organoplatinum Compounds Paclitaxel medicine.medical_treatment Salvage therapy Radiosurgery Deoxycytidine Disease-Free Survival Young Adult chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Nedaplatin Salvage Therapy Chemotherapy Ifosfamide Brain Neoplasms business.industry Liver Neoplasms Combination chemotherapy Hematology General Medicine Middle Aged Neoplasms Germ Cell and Embryonal medicine.disease Gemcitabine Regimen Treatment Outcome chemistry Drug Resistance Neoplasm Lymphatic Metastasis Catheter Ablation Radiotherapy Adjuvant Surgery Cisplatin business medicine.drug Brain metastasis |
| Zdroj: | International Journal of Clinical Oncology. 14:436-441 |
| ISSN: | 1437-7772 1341-9625 |
| DOI: | 10.1007/s10147-009-0899-y |
| Popis: | We investigated the efficacy and toxicity of a regimen consisting of paclitaxel and gemcitabine plus nedaplatin, a derivative of cisplatin (TGN) in patients with heavily pretreated cisplatin-refractory germ cell tumors (GCTs).Fifteen patients with advanced GCTs were treated with the TGN regimen. The combination chemotherapy consisted of paclitaxel (210 mg/m(2)) on day 1 and gemcitabine (1000 mg/m(2)) on days 1 and 8 in combination with nedaplatin (100 mg/m(2)) on day 2 every 3 weeks.Patients enrolled in this study had been heavily pretreated with a median of 12 platinum-containing cycles (range, 7 to 26 cycles). Most of the regimens had included paclitaxel and ifosfamide plus cisplatin or nedaplatin (TIP/TIN) chemotherapy. The median follow-up period of the present study was 15 months. Patients received 2-11 cycles of the TGN combination chemotherapy. Six patients received the treatment combined with other therapeutic modalities; 2 patients received radiation therapy for retroperitoneal lymph node metastasis, 1 patient had cyber-knife radiosurgery for brain metastasis and 3 patients had radiofrequency ablation for liver and lung metastasis. Seven (46.7%) of the 15 patients achieved an objective response; 6 had marker-negative partial responses (PRs) and 1 had a marker-positive PR. Two (13%) of the 7 patients with PRs achieved a disease-free status after chemotherapy combined with RT and followed by surgical resection. However, 10 patients died of the disease and 3 patients are still alive with the disease.The TGN regimen alone had limited efficacy in this patient population, with severe but manageable toxicities. However, TGN chemotherapy may offer a chance of cure for some heavily pretreated cisplatin-refractory (TIP/TIN-refractory) patients as part of multidisciplinary therapy. |
| Databáze: | OpenAIRE |
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