PILOT-STUDY OF A HIGH-DOSE CARBOPLATIN-BASED SALVAGE STRATEGY FOR RELAPSING OR REFRACTORY GERM-CELL CANCER

Eleven patients with germ cell cancer relapsing from a complete remiss ion and 7 patients with refractory germ cell cancer and/or an unresect able partial remission received salvage chemotherapy with one to two c ourses of carboplatin (800 mg/m(2)) and etoposide (500 mg/m(2) on days 1, 3, and 5), followed by either one or two courses of carboplatin (1 600 mg/m(2)), cyclophosphamide (6 g/m(2)), and thiotepa (480 mg/m(2)) divided over 4 days with autologous bone marrow transplantation and/or peripheral stem cell support. Eight of 11 relapsing patients (73%) we re salvaged (with a follow-up of 21+ to 56+ months), but only 1 of the 7 refractory patients survived (34+ months). The high-dose carboplati n-based salvage regimen is feasible and deserves further evaluation in patients relapsing from a complete remission. Even more intensive tre atment strategies may be required to salvage patients who are refracto ry to standard doses of platinating agents.