The role of ifosfamide plus cisplatinā€based chemotherapy as salvage therapy for patients with refractory germ cell tumors Academic Article Article uri icon

Overview

MeSH Major

  • Antigens, Neoplasm
  • Gene Expression Regulation, Developmental
  • Membrane Proteins
  • Neoplasm Proteins
  • Placenta
  • Trophoblasts

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.

publication date

  • January 1990

Research

keywords

  • Academic Article

Identity

Digital Object Identifier (DOI)

  • 10.1002/1097-0142(19901215)66:12<2476::AID-CNCR2820661206>3.0.CO;2-D

PubMed ID

  • 2174300

Additional Document Info

start page

  • 2476

end page

  • 81

volume

  • 66

number

  • 12