Antitumor activity of paclitaxel after failure of high-dose chemotherapy in a patient with late relapse of a non-seminomatous germ cell tumor.
Although cisplatin-based chemotherapy considerably improved the clinical outcome of patients with metastatic germ cell tumors, approximately 20% of patients fail to achieve a durable remission to first-line treatment and require effective salvage treatment. As only 20-30% of patients can expect disease-free long-term survival after conventional salvage treatment, an increasing proportion of patients has been referred to high-dose chemotherapy with autologous stem cell rescue during recent years. However, high-dose chemotherapy still fails to cure a considerable number of patients, emphasizing the need to continue the search for new active drugs. We report here the case of a patient with late relapse of a non-seminomatous germ cell tumor who failed to respond to high-dose chemotherapy after heavy pretreatment with 11 cycles of cisplatin-based chemotherapy. The patient received paciltaxel for symptomatic disease with hepatic and pulmonary metastases, and attained a partial remission. Despite the heavy pretreatment, hematologic toxicity of paciltaxel was tolerable. As recent reports described responses to single-agent paciltaxel in a quarter of pretreated patients with germ cell tumors, further clinical trials seem justified to study the role of paciltaxel in combination regimens against this cancer type.
Medizinische Klinik III, Klinikum Grosshadem, University of Munich, Germany.
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Gerl
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Wilmanns
D000328:Adult; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use*; D018236:Carcinoma, Embryonal / Q000188:drug therapy*; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000188:drug therapy*; D013921:Thrombocytopenia / Q000139:chemically induced
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel