title: Carboplatin AUC 10 for IGCCCG good prognosis metastatic seminoma.
abstract: OBJECTIVE
  Metastatic seminoma is a highly curable disease. Standard treatment comprises of combination chemotherapy. The short- and long-term toxicities of this treatment are increasingly recognised and the possibility of over treatment in such a curable disease should be considered. We have therefore assessed the use of single agent carboplatin at a dose of AUC 10 in patients with good prognosis metastatic seminoma.
  
  
  METHODS
  Patients with good prognosis metastatic seminoma treated with carboplatin (AUC 10) were identified at our institution and affiliated institutions. Treatment was three weekly for a total of three or four cycles. Outcome and toxicities were analysed.
  
  
  RESULTS
  With a median follow-up of 36 months, 61 patients in total were treated with carboplatin AUC 10, all good prognosis by the IGCCCG criteria. Forty-eight percent had stage IIA/IIB disease and 52% had greater than stage IIB disease. Thirty-one patients (51%) had a complete response following treatment. Three-year survival was 96.3% with a three-year progression free survival of 93.2%. The main treatment toxicity was haematological with 46% having grade 3, 24% having grade 4 neutropenia and 54% experiencing grade 3/4 thrombocytopenia. There were no treatment related deaths.
  
  
  CONCLUSIONS
  Single agent carboplatin at a dose of AUC 10 is an effective treatment for good prognosis metastatic seminoma. The outcome compares favourably to previously published outcomes of combination chemotherapy. Although haematological toxicity is a concern, single agent carboplatin treatment for good prognosis metastatic seminoma could be considered a treatment option and is associated with less toxicity than combination regimens currently used.
authors.affiliation: Department of Medical Oncology, St Bartholomew's Hospital, West Smithfield, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Tookman
authors.forename: Sukaina
authors.initials: S
authors.lastname: Rashid
authors.forename: Athena
authors.initials: A
authors.lastname: Matakidou
authors.forename: Melissa
authors.initials: M
authors.lastname: Phillips
authors.forename: Peter
authors.initials: P
authors.lastname: Wilson
authors.forename: Wendy
authors.initials: W
authors.lastname: Ansell
authors.forename: Mariam
authors.initials: M
authors.lastname: Jamal-Hanjani
authors.forename: Simon
authors.initials: S
authors.lastname: Chowdhury
authors.forename: Stephen
authors.initials: S
authors.lastname: Harland
authors.forename: Naveed
authors.initials: N
authors.lastname: Sarwar
authors.forename: Timothy
authors.initials: T
authors.lastname: Oliver
authors.forename: Thomas
authors.initials: T
authors.lastname: Powles
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shamash
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D012189:Retrospective Studies; D018239:Seminoma / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin