Early intensified chemotherapy with autologous bone marrow transplantation in first line treatment of poor risk non-seminomatous germ cell tumours. Preliminary results of a French randomized trial

• Published in: European urology Vol. 23; no. 1; p. 213
• Main Authors: Chevreau, C, Droz, J P, Pico, J L, Biron, P, Kerbrat, P, Cure, H, Héron, J F, Chevallier, B, Fargeot, P, Kramar, A
• Format: Journal Article
• Language: English
• Published: Switzerland 1993
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers, Tumor - blood; Bone Marrow Transplantation; Combined Modality Therapy; Humans; Male; Mediastinal Neoplasms - therapy; Neoplasms, Germ Cell and Embryonal - blood; Neoplasms, Germ Cell and Embryonal - secondary; Neoplasms, Germ Cell and Embryonal - therapy; Remission Induction; Retroperitoneal Neoplasms - therapy; Risk; Testicular Neoplasms - therapy
• ISSN: 0302-2838
• DOI: 10.1159/000474596

For 30 months we have treated 115 non-pretreated non-seminomatous germ cell tumour (NSGCT) patients with poor risk characteristics. Patients were allocated randomly to either arm A: NCI regimen with vinblastine, etoposide (E), bleomycin and double dose cisplatin (P2) (PVeBV) 3 or 4 cycles Q3W, or arm B: modified PVeBV protocol (bleomycin in continuous infusion) Q4W than a cycle of high-dose E + cyclophosphamide + P2 (PEC) and autologous bone marrow transplantation (ABMT). 114 patients are evaluable: 81 testicular, 18 mediastinal and 15 retroperitoneal primaries. Arm A 57 patients: 7 patients did not complete the treatment. There were 15 failures, 9 PR, 33 CR. Seven patients relapsed. The 2-year survival is 82%. Arm B 57 patients: 16 patients did not complete the treatment. There were 26 failures, 7 PR and 24 CR. Nine patients relapsed. The 2-year survival is 60%. Both CR rates and survival are not statistically different. This trial fails to show any benefit of early intensified chemotherapy + ABMT to increase the CR and survival rates in poor risk NSGCT.