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Combination
chemotherapy with gemcitabine and docetaxel for recurrent germ cell tumors in
the central nervous system
J. Ikeda, H. Kobayashi, N. Ishii, Y. Sawamura, H. Aoyama, H. Shirato
Hokkaido University, Graduate School of Medicine, Sapporo,
Hokkaido, Japan.
Background. Through the use of
cisplatin-based combination chemotherapy and radiotherapy, outcomes have
improved for patients with intracranial germ cell tumor.
An appropriate therapy for recurrent germ cell tumors, however, remains to be
established.
The present feasibility study investigates the toxicity and activity of a
gemcitabine/docetaxel combination in patients with multiply relapsed germ cell
tumor.
Methods. Gemcitabine was administered at
a dose of 1000 mg/m2 over 30 minutes on days 1, 8 followed by
docetaxel (1 h-infusion) at a dose of 60 mg/m2 on day 8, with courses
repeated every 21 days.
Results. From 9/00 to 9/01 5 patients
with a median age of 15 [13-32] years were enrolled.
Patients had been pretreated with a median of 9 [3-16] platin-containing cycles
and 1 patient had previously failed high-dose chemotherapy with PBSCT.
All patients were considered cisplatin-refractory.
Median number of applied cycles was 2 [2-4].
All patients achieved a radiological partial response with a tumor marker
normalization resulting in an objective response rate of 100%.
However, the remissions after chemotherapy alone were not durable.
Three of the 5 patients received an additional low-dose of irradiation following
the chemotherapy.
Median progression-free interval was 26 [7-39+] months with 2 patients remaining
without disease progression for more than 30 months.
Toxicity was generally acceptable: CTC grade III/IV neutropenia of short
duration occurred in all patients.
No case of grade III/IV non-hematological adverse effect was observed.
Conclusions. The combination of
gemcitabine/docetaxel is feasible and associated with an acceptable toxicity in
patients with multiply relapsed and cisplatin-refractory germ cell tumor.
It exhibits a significant activity with responses observed in all patients.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-00658,00.asp
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