Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: An Eastern Cooperative Oncology Group, Southwest Oncology Group, and cancer and leukemia group B study

Craig R. Nichols, Paul J. Catalano, E. David Crawford, Nicholas J. Vogelzang, Lawrence Einhorn, Patrick Loehrer

Research output: Contribution to journalArticle

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Abstract

Purpose: To compare standard therapy with bleomycin, etoposide, and cisplatin (BEP) to experimental therapy with etoposide, ifosfamide, and cisplatin (VIP) as primary treatment of men with advanced, disseminated germ cell tumors. Patients and Methods: A total of 304 men with advanced disseminated germ cell tumors were randomly allocated to receive four courses of BEP or VIP. Two hundred ninety-nine patients were assessable for toxicity and 286 were assessable for response. Complete response rates, favorable (complete remission, surgical free of disease, continuous partial remission for 2+ years), time to treatment failure, and overall survival were assessed. Result: Overall complete remission rate (VIP, 37%; BEP%), favorable response rate (VIP, 63%; BEP, 00%), failure-free at 2 years (VIP, 64%; BEP, 60%), and 2-year overall survival (VIP, 74%; BEP, 71%) were not significantly different between the two treatments. Grade 3 or worse toxicity, particularly hematologic and genitourinary toxicity, was significantly more common in patients who received VIP. Conclusion: BEP and VIP produce comparable favorable response rate and survival in patients with poor-risk germ cell tumors. The substitution of ifosfamide for bleomycin, however, was, associated with significantly greater toxicity. Four courses of BEP remain the standard treatment for advanced disseminated germ cell tumors.

Original languageEnglish (US)
Pages (from-to)1287-1293
Number of pages7
JournalJournal of Clinical Oncology
Volume16
Issue number4
StatePublished - Apr 1998
Externally publishedYes

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Ifosfamide
Germ Cell and Embryonal Neoplasms
Bleomycin
Etoposide
Cisplatin
Leukemia
Neoplasms
Therapeutics
Investigational Therapies
Survival
Treatment Failure
Survival Rate

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{0f1f1aed3a0542c9962347fa9fc11f3d,
title = "Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: An Eastern Cooperative Oncology Group, Southwest Oncology Group, and cancer and leukemia group B study",
abstract = "Purpose: To compare standard therapy with bleomycin, etoposide, and cisplatin (BEP) to experimental therapy with etoposide, ifosfamide, and cisplatin (VIP) as primary treatment of men with advanced, disseminated germ cell tumors. Patients and Methods: A total of 304 men with advanced disseminated germ cell tumors were randomly allocated to receive four courses of BEP or VIP. Two hundred ninety-nine patients were assessable for toxicity and 286 were assessable for response. Complete response rates, favorable (complete remission, surgical free of disease, continuous partial remission for 2+ years), time to treatment failure, and overall survival were assessed. Result: Overall complete remission rate (VIP, 37{\%}; BEP{\%}), favorable response rate (VIP, 63{\%}; BEP, 00{\%}), failure-free at 2 years (VIP, 64{\%}; BEP, 60{\%}), and 2-year overall survival (VIP, 74{\%}; BEP, 71{\%}) were not significantly different between the two treatments. Grade 3 or worse toxicity, particularly hematologic and genitourinary toxicity, was significantly more common in patients who received VIP. Conclusion: BEP and VIP produce comparable favorable response rate and survival in patients with poor-risk germ cell tumors. The substitution of ifosfamide for bleomycin, however, was, associated with significantly greater toxicity. Four courses of BEP remain the standard treatment for advanced disseminated germ cell tumors.",
author = "Nichols, {Craig R.} and Catalano, {Paul J.} and Crawford, {E. David} and Vogelzang, {Nicholas J.} and Lawrence Einhorn and Patrick Loehrer",
year = "1998",
month = "4",
language = "English (US)",
volume = "16",
pages = "1287--1293",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
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TY - JOUR

T1 - Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors

T2 - An Eastern Cooperative Oncology Group, Southwest Oncology Group, and cancer and leukemia group B study

AU - Nichols, Craig R.

AU - Catalano, Paul J.

AU - Crawford, E. David

AU - Vogelzang, Nicholas J.

AU - Einhorn, Lawrence

AU - Loehrer, Patrick

PY - 1998/4

Y1 - 1998/4

N2 - Purpose: To compare standard therapy with bleomycin, etoposide, and cisplatin (BEP) to experimental therapy with etoposide, ifosfamide, and cisplatin (VIP) as primary treatment of men with advanced, disseminated germ cell tumors. Patients and Methods: A total of 304 men with advanced disseminated germ cell tumors were randomly allocated to receive four courses of BEP or VIP. Two hundred ninety-nine patients were assessable for toxicity and 286 were assessable for response. Complete response rates, favorable (complete remission, surgical free of disease, continuous partial remission for 2+ years), time to treatment failure, and overall survival were assessed. Result: Overall complete remission rate (VIP, 37%; BEP%), favorable response rate (VIP, 63%; BEP, 00%), failure-free at 2 years (VIP, 64%; BEP, 60%), and 2-year overall survival (VIP, 74%; BEP, 71%) were not significantly different between the two treatments. Grade 3 or worse toxicity, particularly hematologic and genitourinary toxicity, was significantly more common in patients who received VIP. Conclusion: BEP and VIP produce comparable favorable response rate and survival in patients with poor-risk germ cell tumors. The substitution of ifosfamide for bleomycin, however, was, associated with significantly greater toxicity. Four courses of BEP remain the standard treatment for advanced disseminated germ cell tumors.

AB - Purpose: To compare standard therapy with bleomycin, etoposide, and cisplatin (BEP) to experimental therapy with etoposide, ifosfamide, and cisplatin (VIP) as primary treatment of men with advanced, disseminated germ cell tumors. Patients and Methods: A total of 304 men with advanced disseminated germ cell tumors were randomly allocated to receive four courses of BEP or VIP. Two hundred ninety-nine patients were assessable for toxicity and 286 were assessable for response. Complete response rates, favorable (complete remission, surgical free of disease, continuous partial remission for 2+ years), time to treatment failure, and overall survival were assessed. Result: Overall complete remission rate (VIP, 37%; BEP%), favorable response rate (VIP, 63%; BEP, 00%), failure-free at 2 years (VIP, 64%; BEP, 60%), and 2-year overall survival (VIP, 74%; BEP, 71%) were not significantly different between the two treatments. Grade 3 or worse toxicity, particularly hematologic and genitourinary toxicity, was significantly more common in patients who received VIP. Conclusion: BEP and VIP produce comparable favorable response rate and survival in patients with poor-risk germ cell tumors. The substitution of ifosfamide for bleomycin, however, was, associated with significantly greater toxicity. Four courses of BEP remain the standard treatment for advanced disseminated germ cell tumors.

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