Irinotecan plus cisplatin has substantial antitumor effect as salvage chemotherapy against germ cell tumors

• Published in: Cancer Vol. 95; no. 9; pp. 1879 - 1885
• Main Authors: Miki, Tsuneharu, Mizutani, Yoichi, Nonomura, Norio, Nomoto, Takeshi, Nakao, Masahiro, Saiki, Shigeru, Kotake, Toshihiko, Okuyama, Akihiko
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.11.2002; Wiley-Liss
• Subjects: Adolescent; Adult; Antineoplastic agents; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Agents, Phytogenic - adverse effects; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Biomarkers, Tumor - blood; Camptothecin - administration & dosage; Camptothecin - adverse effects; Camptothecin - analogs & derivatives; Chemotherapy; cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; germ cell tumor; Germinoma - diagnosis; Germinoma - drug therapy; Humans; irinotecan; Male; Medical sciences; nedaplatin; Pharmacology. Drug treatments; Pilot Projects; salvage chemotherapy; Salvage Therapy; Antineoplastic agent; Human; Drug combination; Enzyme; Toxicity; Treatment efficiency; DNA topoisomerase; Enzyme inhibitor; Cisplatin; Germ cell tumor; Irinotecan; Alkylating agent; Chemotherapy; salvage chemotherapy; Isomerases; Treatment; Nedaplatin; Evolution; Platinum II Complexes
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.10918

BACKGROUND Only 20–30% of patients with refractory or recurrent germ cell tumors (GCT) are cured by salvage chemotherapy. Irinotecan, a new derivative of camptothecin, is a potent anticancer agent against a variety of solid cancers. The current pilot study investigated the efficacy of salvage chemotherapy with irinotecan in combination with cisplatin (CDDP) or nedaplatin (NDP), a derivative of cisplatin, for GCT. METHODS The combination chemotherapy consisted of 100–150 mg/m2 irinotecan on Days 1 and 15 or 200–300 mg/m2 on Day 1 in combination with 20 mg/m2 CDDP on Days 1–5 or 100 mg/m2 NDP on Day 1 every 4 weeks. Patients with refractory GCT, ranging in age from 17 to 43 years, received 2–11 cycles of the combination chemotherapy. The median duration of follow‐up is 28 months (8–140 months). RESULTS Twenty patients entered this study, 18 of whom were assessed for response and toxicity. The response rate was 50 % (two complete responses and seven partial responses). Nine patients remain alive without disease. However, six patients died of the disease and one patient died of a brain glioma. The 5‐year survival rate was approximately 53%. Myelosuppression was the major toxicity, but was manageable. CONCLUSIONS This pilot study demonstrates that the chemotherapy with irinotecan in combination with CDDP or NDP showed significant anticancer activity for patients with refractory GCT, without serious side effects. Although this study comprised only a few patients, these findings suggest that the combination chemotherapy may be one of the options of salvage chemotherapy for patients with refractory GCT. Cancer 2002;95:1879–85. © 2002 American Cancer Society. DOI 10.1002/cncr.10918 Chemotherapy with irinotecan in combination with cisplatin or nedaplatin showed significant anticancer activity for patients with refractory germ cell tumors, without serious side effects. This combination chemotherapy may be one of the options of salvage chemotherapy for patients with refractory germ cell tumor.