Salvage chemotherapy with docetaxel, ifosfamide and nedaplatin (DIN) for patients with advanced germ cell tumors: a preliminary report

• Published in: Japanese journal of clinical oncology Vol. 43; no. 7; pp. 734 - 739
• Main Authors: Yamada, Shigeyuki, Saito, Hideo, Ohara, Shinya, Yamashita, Shinichi, Mitsuzuka, Koji, Namiki, Shunichi, Miyazato, Minoru, Kaiho, Yasuhiro, Ito, Akihiro, Nakagawa, Haruo, Ishidoya, Shigeto, Arai, Yoichi
• Format: Journal Article
• Language: English
• Published: England 01.07.2013
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Docetaxel; Drug Administration Schedule; Drug Resistance, Neoplasm; Humans; Ifosfamide - administration & dosage; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - pathology; Organoplatinum Compounds - administration & dosage; Recurrence; Salvage Therapy - methods; Taxoids - administration & dosage; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology; Treatment Outcome; ifosfamide; salvage chemotherapy; docetaxel; germ cell tumor; nedaplatin
• ISSN: 0368-2811; 1465-3621
• DOI: 10.1093/jjco/hyt060

We investigated the efficacy and toxicity of a docetaxel, ifosfamide and nedaplatin regimen as salvage therapy for patients with advanced testicular germ cell tumor. Eleven patients with advanced germ cell tumor refractory or relapsed after cisplatin-based chemotherapy were treated using docetaxel, ifosfamide and nedaplatin. The docetaxel, ifosfamide and nedaplatin regimen comprised docetaxel (75 mg/m(2)) on Day 1, ifosfamide (2 g/m(2)) on Days 1-3 and nedaplatin (75 mg/m(2)) on Day 2 of a 3-week cycle. Ten (91%) of the 11 patients achieved favorable responses, including complete response in one case and partial response in nine cases. Nine (81%) of the 11 patients have continued to show no evidence of disease after docetaxel, ifosfamide and nedaplatin therapy followed by subsequent surgical resection, with a median follow-up period of 52 months. One patient died of the disease 3 months after completing docetaxel, ifosfamide and nedaplatin chemotherapy. One patient was lost to follow-up with a status of alive with disease. Ten (91%) of the 11 patients developed Grade 4 leukopenia, which was managed using granulocyte colony-stimulating factor. No patients developed sensory neuropathy or renal dysfunction. The docetaxel, ifosfamide and nedaplatin regimen was efficacious and well-tolerated as salvage chemotherapy for patients with advanced germ cell tumor.