Management of poor‐prognosis or relapsed germ‐cell cancer

Daugaard, Gedske

doi:10.1111/j.1464-410x.2009.08865.x

Cited by 5 publications

(9 citation statements)

References 62 publications

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“…1 However, non-responders to upfront chemotherapy and relapsed patients have an inferior outcome. 1 In this setting, high-dose chemotherapy with autologous stem cell support is currently the treatment of choice, 2 and permits cure in 10-60% of patients. 2 Accordingly, auto-SCT is a potentially life-saving procedure for these germ cell tumor patients.…”

Section: Introductionmentioning

confidence: 99%

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Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients

Kobold

Isernhagen

Hübel

et al. 2010

Bone Marrow Transplant

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Section: Introductionmentioning

confidence: 99%

“…Frequently, several lines of therapy had been applied. 1 Those patients are at high risk to be poor mobilizers, which is likely to impair their eligibility for HDCT and their prognosis. New strategies for stem cell mobilization are needed in this setting.…”

Section: Introductionmentioning

confidence: 99%

Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients

Kobold

Isernhagen

Hübel

et al. 2010

Bone Marrow Transplant

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“…For patients who are appropriate for chemotherapy by staging, a cisplatin-based regimen such as cisplatin, bleomycin, and etoposide (BEP) is commonly used [1]. Around 10% of the patients relapse after first complete remission [2].…”

Section: Introductionmentioning

confidence: 99%

Delayed rhabdomyolysis with paclitaxel, ifosfamide, carboplatin, and etoposide regimen: a case report

Sokolova¹,

Chan²,

Ullah³

et al. 2017

J Med Case Reports

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BackgroundHigh-dose chemotherapy with autologous stem cell rescue is commonly used for the treatment of relapsed germ cell tumors. We report the first case of delayed rhabdomyolysis with paclitaxel, ifosfamide, carboplatin, and etoposide regimen.Case presentationWe report a case of a 21-year-old African-American man diagnosed with relapsed non-seminomatous germ cell tumor who received high-dose chemotherapy with carboplatin and etoposide following TIGER trial arm B off-protocol. His course was complicated by muscle pain and rhabdomyolysis after cycle 4 on day +12 after infusion of autologous stem cells. To the best of our knowledge, this complication has not been reported with this regimen. A differential diagnosis of sepsis and neutropenic fever along with side effects of high-dose chemotherapy were considered, but based on the timing of events, it was concluded that the etiology of rhabdomyolysis is high-dose chemotherapy. Rhabdomyolysis was successfully treated with hydration and did not recur during subsequent cycle 5.ConclusionsDelayed rhabdomyolysis after high-dose chemotherapy with paclitaxel, ifosfamide, carboplatin, and etoposide regimen has not been previously reported and needs to be considered for preventive strategy and prompt diagnosis and treatment to avoid renal complications. Physicians should have a low threshold to check creatine kinase enzymes in patients with unexplained muscle pain or renal insufficiency after high-dose chemotherapy.

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“…This treatment is well defined and usually consists of cisplatin based therapy. However, if the disease relapses, outcomes are much less secure and despite further chemotherapy, the majority of patients die from GCT 2,3.…”

Section: Introductionmentioning

confidence: 99%

“…Conventional-dose chemotherapy (CDCT) and high-dose chemotherapy (HDCT) are both used as salvage treatment strategies for patients with metastatic GCTs who experience progression with or after first-line treatment 3,4. At recent international consensus meetings (G3 testis meeting: ASCO 2010) investigators agreed that identifying the optimal initial salvage approach (CDT vs HDT) is the most pressing question remaining in GCTs.…”

Section: Introductionmentioning

confidence: 99%

Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

Feldman¹,

Huddart²,

Hall³

et al. 2011

J. Cancer

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Metastatic germ cell tumours (GCTs) are usually cured with cisplatin based chemotherapy and standard treatment algorithms are established. However when this treatment fails and the disease relapses, standard treatment is much more uncertain. Both conventional dose therapy (CDT) and high dose therapy (HDT) are widely used, due to the lack of conclusive data supporting one specific approach. A recent retrospective analysis focusing on this population suggested a significant benefit for HDT. Retrospective analyses are prone to bias, and therefore while this data is provocative it is by no mean conclusive. For this reason the international community is supporting a prospective randomised trial in this area comparing CDT(TIP) with sequential HDT (TICE). The planned open labelled randomised phase III study (TIGER) is due to open in 2011 and will recruit 390 patients to detect a 13% difference in 2 year progression free survival (primary endpoint). It is hoped that this large study will conclusively resolve the uncertainty which currently exists.

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Management of poor‐prognosis or relapsed germ‐cell cancer

Cited by 5 publications

References 62 publications

Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients

Plerixafor is effective and safe for stem cell mobilization in heavily pretreated germ cell tumor patients

Delayed rhabdomyolysis with paclitaxel, ifosfamide, carboplatin, and etoposide regimen: a case report

Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

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