title: Paclitaxel, ifosfamide and cisplatin regimen is feasible for Japanese patients with advanced germ cell cancer.
abstract: BACKGROUND
  Paclitaxel, ifosfamide and cisplatin (TIP) has been tested with successful results on metastatic testicular cancer in Western countries. Because paclitaxel, the key drug of this regimen, has not been approved for testicular cancer in Japan, there are no established data concerning TIP. The purpose of this study was to assess the feasibility of a TIP regimen for Japanese patients with advanced germ cell cancer.
  
  
  METHODS
  Eight patients with advanced germ cell cancer were treated with TIP that was originally reported by Motzer et al (1). The treatment was used for three refractory cases and two late relapse cases as salvage therapy and for three poor-risk cases with extra-pulmonary visceral metastases as a part of induction chemotherapy. TIP consisted of paclitaxel 175 mg/m(2) by 24 h infusion on day 1, followed by ifosfamide 1.2 g/m(2) infusions over 2 h and cisplatin 20 mg/m(2 )given over 2 h on days 2-6.
  
  
  RESULTS
  Five patients (62%) achieved a disease-free status after chemotherapy and surgical resection of residual tumor. Three of five patients have remained continuously free from disease progression at a median follow-up duration of 24 months and one additional patient is currently free of evidence of disease. Most patients developed grade 3 or 4 leukocytopenia and thrombocytopenia; however, they could be managed with routine supportive care. Sensory neuropathy was frequently seen, but no patient experienced over grade 3 neurotoxicity.
  
  
  CONCLUSIONS
  TIP regimen as salvage chemotherapy is feasible for Japanese patients with advanced germ cell cancer. TIP as a part of induction chemotherapy for poor-risk patients is also feasible; however, larger and longer-term follow-up studies are needed to define the role of TIP in this setting.
authors.affiliation: Institute of Clinical Medicine, Department of Urology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-City, Ibaraki 305, Japan. rkawa@md.tsukuba.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.forename: Sadamu
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: Shiro
authors.initials: S
authors.lastname: Hinotsu
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hattori
authors.forename: Toru
authors.initials: T
authors.lastname: Shimazui
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007970:Leukopenia / Q000139:chemically induced; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage; D016879:Salvage Therapy; D043823:Taxoids; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D043823:Taxoids; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide