Salvage chemotherapy with high-dose carboplatin and etoposide with peripheral blood stem cell transplant in patients with relapsed pure seminoma.
OBJECTIVE
To evaluate rates of complete remission and overall survival for patients with relapsed pure seminoma treated with high-dose carboplatin and etoposide followed by peripheral blood stem cell transplant.


METHODS
Forty-eight consecutive patients with relapsed pure seminoma who were treated with high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplant between May 1996 and June 2006 were retrospectively reviewed. Upon relapse (first, second, or third relapse) patients were given HDCT with carboplatin 700 mg/m(2) and etoposide 750 mg/m(2) for 3 consecutive days followed by infusion of peripheral blood stem cells. Here, we review both response and survival.


RESULTS
Thirty-eight (79%) of 48 patients obtained a complete response (CR) with overall survival of 75%. Median follow-up of all patients was 45.6 months. Twenty-two (92%) of 24 patients in first relapse achieved CR and are still alive and continuously disease-free. Sixteen (67%) of 24 patients had HDCT as third- or fourth-line therapy with 67% CR and overall survival of 64%. There were 3 treatment-related deaths, all of which occurred as third- or fourth-line therapy.


CONCLUSIONS
HDCT results in high rates of both CR and overall survival in patients with first or later relapsed pure seminoma germ cell tumors.
Division of Hematology-Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN 46202, USA.
Anuj K
AK
Agarwala
Susan M
SM
Perkins
Rafat
R
Abonour
Mary J
MJ
Brames
Lawrence H
LH
Einhorn
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D018239:Seminoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D005047:Etoposide; D016190:Carboplatin