Abstract:
:A prospective study of four cycles of etoposide with ifosfamide and cisplatin (VIP) chemotherapy was conducted in 42 germ cell tumor (GCT) patients who were refractory to cisplatin with etoposide/vinblastine-based therapy. Forty patients were evaluable for response. Ten patients (25%) had a complete response: seven to chemotherapy alone and an additional three patients after surgical resection of viable GCT. With a median follow-up of 15 months, four complete responders relapsed, and six patients (15%) remain in remission. Hematologic and nephrotoxicity were moderately severe. Durable complete responses with VIP as second salvage were achieved and suggests that ifosfamide adds efficacy to standard first-salvage therapy. The observed nephrotoxicity and myelotoxicity are considerations in the design of ifosfamide-cisplatin-based regimens. Hematopoietic growth factors may be useful in ameliorating myelotoxicity. The early use of ifosfamide-based chemotherapy may reduce the nephrotoxicity exacerbated by prior cisplatin. A trial of VIP as first salvage after a relapse from a complete response to platinum-based induction therapy is warranted. The modest proportion of patients who achieve a durable remission to VIP as second salvage emphasizes the need for more efficacious salvage therapy for patients who do not achieve a durable complete response.
journal_name
Cancerjournal_title
Cancerauthors
Motzer RJ,Cooper K,Geller NL,Bajorin DF,Dmitrovsky E,Herr H,Morse M,Fair W,Sogani P,Russo Pdoi
10.1002/1097-0142(19901215)66:12<2476::aid-cncr282subject
Has Abstract,Author List Incompletepub_date
1990-12-15 00:00:00pages
2476-81issue
12eissn
0008-543Xissn
1097-0142journal_volume
66pub_type
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