Maintenance chemotherapy with daily oral etoposide following salvage therapy in patients with germ cell tumors

Maureen A. Cooper, Lawrence H. Einhorn

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Purpose: To evaluate the role of maintenance daily oral etoposide (VP-16) chemotherapy for germ cell patients who had a response to salvage therapy. Patients and Methods: Thirty-seven patients were entered onto this trial, and 34 were fully assessable. This was a heavily pretreated patient population, with a median of two prior salvage regimens. The salvage treatment that immediately preceded oral VP-16 consisted of autologous bone marrow transplantation in 14 patients (41%), surgery in 10 (29%), and standard-dose salvage chemotherapy in 10 (29%). Daily oral VP-16 was administered at a dose of 50 mg/m2 for 21 consecutive days every 4 weeks for three cycles. Results: The major toxicity with daily oral VP-16 was leukopenia. Three patients had grade III and two grade IV leukopenia. Two of these patients had granulocytopenic fever. Other grade III toxicities included thrombocytopenia (n = 1) and mucositis (n = 2). Twenty-three patients started daily oral VP- 16 while in complete remission (CR) following salvage therapy. Seventeen (74%) remain continuously disease-free, with a median follow-up time of 36 months (range, 26 to 49) from initiation of daily oral VP-16. Eleven patients started daily oral VP-16 while in partial remission (PR) following salvage therapy. Three of these 11 patients converted to CR, but all three subsequently relapsed. Conclusion: Maintenance oral VP-16 was well tolerated in this heavily treated patient population. Results in this poor-risk population were encouraging.

Original languageEnglish (US)
Pages (from-to)1167-1169
Number of pages3
JournalJournal of Clinical Oncology
Volume13
Issue number5
DOIs
StatePublished - May 1995

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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