Paclitaxel, ifosfamide, and nedaplatin (TIN) salvage chemotherapy for patients with advanced germ cell tumors.
BACKGROUND
The paclitaxel, ifosfamide, and cisplatin regimen has been used to treat metastatic testicular cancer with successful results. We investigated the usefulness of a paclitaxel, ifosfamide, and nedaplatin (TIN) regimen as salvage therapy for patients with advanced testicular germ cell tumors (GCTs).


METHODS
Eight patients with advanced GCTs were treated with TIN. The treatment was performed as salvage therapy for cases refractory to therapies, such as bleomycin, etoposide and cisplatin, and irinotecan with nedaplatin. The TIN regimen consisted of paclitaxel (200 mg/m(2)) by 24-h infusion on day 1, followed by ifosfamide (1.2 g/m(2)) infusions over 2 h on days 2-6, and nedaplatin (100 mg/m(2)) given over 2 h on day 2.


RESULTS
Seven out of eight patients achieved a disease-free status after chemotherapy, followed by surgical resection of the residual tumor. Six of the seven patients have continued to show no evidence of disease after salvage therapy, with a median follow-up period of 27 months, but one patient developed a 'growing teratoma syndrome' in the mediastinum 31 months after TIN chemotherapy. All patients developed grade 4 leukocytopenia. However, it could be managed by using granulocyte colony-stimulating factor. Only one patient developed grade 2 sensory neuropathy and no patient developed nephrotoxicity.


CONCLUSIONS
The TIN regimen was efficacious and well-tolerated as salvage chemotherapy for Japanese patients with advanced GCTs.
Nonomura
Norio
N
Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan. nono@uro.med.osaka-u.ac.jp
Oka
Daizo
D
Nishimura
Kazuo
K
Nakayama
Masashi
M
Inoue
Hitoshi
H
Mizutani
Yoichi
Y
Miki
Tsuneharu
T
Okuyama
Akihiko
A
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016879:Salvage Therapy / Q000379:methods*; D013736:Testicular Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D018906:Antineoplastic Agents, Alkylating; D000972:Antineoplastic Agents, Phytogenic; D009944:Organoplatinum Compounds; C053989:nedaplatin; D017239:Paclitaxel; D007069:Ifosfamide