ELEVATED GERM-CELL MARKERS IN CARCINOMA OF UNCERTAIN PRIMARY SITE DO NOT PREDICT RESPONSE TO PLATINUM-BASED CHEMOTHERAPY

We carried out a retrospective review of the medical records of patien ts with metastatic carcinoma of unknown primary and either raised alph a fetoprotein (AFP) or beta human chorionic gonadotrophin (beta HCG) o ver a period of 6 years at three teaching hospital oncology units to a ssess response to platinum based chemotherapy. 15 patients were identi fied who fitted these criteria. Of these, 3 received no treatment beca use of poor functional status, 2 patients received only radiotherapy f or symptomatic disease and died within 3 months of diagnosis and 1 pat ient died 2 weeks after diagnosis having received his first cycle of c isplatin-based chemotherapy. 9 patients received at least 2 cycles of chemotherapy. A complete tumour response was seen in only one patient who presented with midline lymphadenopathy and remains disease-free 46 months after treatment. This presentation was consistent with disease already known to herald platinum sensitivity. In the other 8 patients , there was only one partial response that lasted 2 months. The median survival for this group of 9 patients was 4.5 months (range 3 to >36 months). Our data do not support the postulate that elevated germ cell markers in patients with carcinoma of unknown primary predict a respo nse to cisplatin based chemotherapy. Copyright (C) 1996 Elsevier Scien ce Ltd