High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity.

2.50
Hdl Handle:
http://hdl.handle.net/10541/86471
Title:
High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity.
Authors:
Decatris, M P; Wilkinson, Peter M; Welch, Richard; Metzner, M; Morgenstern, Godfrey R; Dougal, Mark
Abstract:
BACKGROUND: The prognosis of patients with high-risk germ-cell cancer is poor. The toxicity and efficacy of first-line high-dose chemotherapy (HDCT) with stem-cell support was evaluated, following induction chemotherapy with BEP. PATIENTS AND METHODS: Twenty patients with poor prognosis non seminomatous germ-cell tumour by the International Consensus prognostic criteria received induction with BEP followed by one cycle of HDCT (CEC) given with carboplatin (1800 mg/m2), etoposide (1800 mg/m2), and cyclophosphamide (140 mg/kg). Of the above 20 patients only 3 received a second cycle of HDCT. Peripheral blood stem cells were infused on day 0. RESULTS: Twenty patients were assessable for toxicity and response. After a median follow-up of 27 months 15 patients (75%) are alive, 12 (60%) are disease free and 3 (15%) are alive with disease. Median survival has not been reached and overall survival at four years is 66% with a durable complete response rate of 50%. There were no deaths or cases of severe toxicity. Median time to a granulocyte count > 500/microl and platelets > 20,000/microl was 10 and 12 days respectively. Five patients have died from progressive disease 5-35 months after HDCT. CONCLUSIONS: These results support the case of first-line HDCT. The excellent toxicity profile of BEP/CEC and the two-year overall survival of 78% are encouraging and support further the ongoing randomised US intergroup study evaluating high-dose CEC after BEP.
Affiliation:
Department of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.
Citation:
High-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity. 2000, 11 (4):427-34 Ann. Oncol.
Journal:
Annals of Oncology
Issue Date:
Apr-2000
URI:
http://hdl.handle.net/10541/86471
PubMed ID:
10847461
Type:
Article
Language:
en
ISSN:
0923-7534
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorDecatris, M Pen
dc.contributor.authorWilkinson, Peter Men
dc.contributor.authorWelch, Richarden
dc.contributor.authorMetzner, Men
dc.contributor.authorMorgenstern, Godfrey Ren
dc.contributor.authorDougal, Marken
dc.date.accessioned2009-11-19T15:16:16Z-
dc.date.available2009-11-19T15:16:16Z-
dc.date.issued2000-04-
dc.identifier.citationHigh-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity. 2000, 11 (4):427-34 Ann. Oncol.en
dc.identifier.issn0923-7534-
dc.identifier.pmid10847461-
dc.identifier.urihttp://hdl.handle.net/10541/86471-
dc.description.abstractBACKGROUND: The prognosis of patients with high-risk germ-cell cancer is poor. The toxicity and efficacy of first-line high-dose chemotherapy (HDCT) with stem-cell support was evaluated, following induction chemotherapy with BEP. PATIENTS AND METHODS: Twenty patients with poor prognosis non seminomatous germ-cell tumour by the International Consensus prognostic criteria received induction with BEP followed by one cycle of HDCT (CEC) given with carboplatin (1800 mg/m2), etoposide (1800 mg/m2), and cyclophosphamide (140 mg/kg). Of the above 20 patients only 3 received a second cycle of HDCT. Peripheral blood stem cells were infused on day 0. RESULTS: Twenty patients were assessable for toxicity and response. After a median follow-up of 27 months 15 patients (75%) are alive, 12 (60%) are disease free and 3 (15%) are alive with disease. Median survival has not been reached and overall survival at four years is 66% with a durable complete response rate of 50%. There were no deaths or cases of severe toxicity. Median time to a granulocyte count > 500/microl and platelets > 20,000/microl was 10 and 12 days respectively. Five patients have died from progressive disease 5-35 months after HDCT. CONCLUSIONS: These results support the case of first-line HDCT. The excellent toxicity profile of BEP/CEC and the two-year overall survival of 78% are encouraging and support further the ongoing randomised US intergroup study evaluating high-dose CEC after BEP.en
dc.language.isoenen
dc.subjectGerm Cell and Embryonal Canceren
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBleomycin-
dc.subject.meshCarboplatin-
dc.subject.meshCisplatin-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshCyclophosphamide-
dc.subject.meshDose-Response Relationship, Drug-
dc.subject.meshDrug Administration Schedule-
dc.subject.meshEtoposide-
dc.subject.meshFemale-
dc.subject.meshHematopoietic Stem Cell Transplantation-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshNeoplasms, Germ Cell and Embryonal-
dc.subject.meshRisk Factors-
dc.subject.meshSurvival Analysis-
dc.subject.meshTreatment Outcome-
dc.titleHigh-dose chemotherapy and autologous haematopoietic support in poor risk non-seminomatous germ-cell tumours: an effective first-line therapy with minimal toxicity.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Oncology, Christie Hospital NHS Trust, Manchester, UK.en
dc.identifier.journalAnnals of Oncologyen

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