Oncology Medical News about cisplatin-based chemotherapy;advanced seminoma

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Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions
Journal of Cancer Research & Clinical Oncology, 05/19/09

Giannis M et al. - In a study to evaluate an intensified therapeutic strategy in order to optimize treatment outcomes while maintaining acceptable toxicity in pts with advanced seminoma, it seems that intensified cisplatin-based chemotherapy for pts with advanced seminoma does not confer evidence of superiority over radiotherapy alone or the standard BEP regimen. Pts with low-volume abdominal disease (clinical stage IIA and IIB) can be cured by four cycles of BEP instead of radiotherapy at the cost of a substantial increase in chemotherapy exposure and the resulting toxicity.

Methods

52 pts with advanced pure seminoma were retrospectively evaluated.
Pts with low-risk advanced seminoma had received 4 cycles of the BEP regimen either in the 5-day or the alternative 3-day schedule, while pts with intermediate-risk advanced seminoma had received 4 cycles of the IBEP regimen.

Results

42 pts (80.7%) had testicular seminoma while 10 pts (19.3%) presented with primary extragonadal (mediastinal or retroperitoneal) tumor.
47 (90.8%) pts belonged to the low-risk group and 5 pts (9.2%) to the intermediate-risk group.
Treatment-related toxicity was moderate, with febrile neutropenia being the most prevalent (13.5%).
20 pts (38.5%) achieved a complete response to chemotherapy; 23 from the remaining 32 pts had residual masses more than 3 cm and were submitted to surgery (2 pts), FDG-PET scan (8 pts), or surveillance (13 pts).
After 69 mos of follow-up, there were 3 recurrences that were successfully treated with high-dose or salvage chemotherapy.

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