[Salvage chemotherapy with paclitaxel, ifosphamide and nedaplatin for relapsed or refractory germ cell cancer].
OBJECTIVE
Only 20-30% of patients with cisplatin refractory or relapsed germ cell cancer will remain continuously disease free with salvage chemotherapy. Paclitaxel is a potent anticancer agent against a variety of solid cancers. The present study investigated the chemotherapy with paclitaxel in combination with nedaplatin, which is a derivative of cisplatin, and ifosphamide as salvage chemotherapy for cisplatin refractory germ cell cancer.


METHODS
The combination chemotherapy consisted of paclitaxel 210 mg/m2 on day 1, nedaplatin 100 mg/m2 on day 2 and ifosphamide 1.2 g/m2 on day 2-day 6 every three weeks. Fourteen patients with cisplatin refractory germ cell cancer, ranging in age from 17 to 44 years were enrolled onto the study.


RESULTS
Fourteen patients were evaluated for response and toxicity. Patients received 1-14 cycles of the combination chemotherapy. The median duration of follow-up was 34 months (10-64 months). Response rate was 57.1% (CR / PR(m-):8 cases, NC:5 cases, PD:1 cases). Seven patients remain alive without disease. However, 5 patients died of the disease. All patients had grade 3 or 4 hematological toxicity.


CONCLUSIONS
This study demonstrates that the chemotherapy with paclitaxel in combination with nedaplatin and ifosphamide showed a significant anticancer activity for patients with cisplatin refractory or relapsed germ cell cancer. These findings suggest that the combination chemotherapy may be one of the options of salvage chemotherapy for cisplatin refractory or relapsed germ cell cancer.
Nomoto
Takeshi
T
Kyoto Prefectural University of Medicine, Kyoto.
Mizutani
Yoichi
Y
Mikami
Kazuya
K
Nakamura
Terukazu
T
Nakanishi
Hiroyuki
H
Kawauchi
Akihiro
A
Miki
Tsuneharu
T
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects; D004334:Drug Administration Schedule; D019008:Drug Resistance, Neoplasm; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D017239:Paclitaxel / Q000008:administration & dosage; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013921:Thrombocytopenia / Q000139:chemically induced
D009944:Organoplatinum Compounds; C053989:nedaplatin; D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide