GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours.

GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Research Abstract Details 

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GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Abstract Text:

J Shamash,T Powles,W Ansell,Dan Berney,J Stebbing,K Mutsvangwa,P Wilson,S Asterling,S Liu,P Wyatt,S P Joel,R T D Oliver,

There is no consensus as to the management of untreated poor prognosis or relapsed/refractory germ cell tumours. We have studied an intensive cisplatin-based regimen that incorporates high-dose methotrexate (HD MTX) and actinomycin-D and etoposide every 14 days (GAMEC). Sixty-two patients were enrolled in a phase 2 study including 27 who were untreated (IGCCCG, poor prognosis) and 35 with progression despite conventional platinum based chemotherapy. The pharmacokinetics of the drugs were correlated with standard outcome measures. Twenty of the untreated patients were progression free following GAMEC and appropriate surgery, as were 18 individuals in the pretreated group. None of the established prognostic factors for therapy for pretreated patients could identify a poor-prognosis group. Five out of nine late relapses to prior chemotherapy were progression free following GAMEC and appropriate surgery. All patients had at least one episode of febrile neutropenia and there were five (8%) treatment-related deaths. PK values were not predictive of efficacy or toxicity, although the dose intensity in the pretreated group of patients, especially of HD MTX, was significantly correlated with progression-free survival (PFS). GAMEC is a novel intensive regimen for this group of patients producing encouraging responses, although with significant toxicity. For those in whom it fails, further therapy is still possible with durable responses being seen.

GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Publishing Authors By Initials

J Shamash,T Powles,W Ansell,D Berney,J Stebbing,K Mutsvangwa,P Wilson,S Asterling,S Liu,P Wyatt,SP Joel,RT Oliver,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: British journal of cancer

VOLUME: 97

Page Numbers: 308-14

Journal Abbreviation: Br. J. Cancer

ISSN: 0007-0920

DAY: 3

MONTH: 07

YEAR: 2007

GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 370635

GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: drug therapy

Chemical & Substance for Abstract: GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours. Information

Substance Name: Methotrexate

Registry Number: 59-05-2

Grant and Affiliation Information for GAMEC--a new intensive protocol for untreated poor prognosis and relapsed or refractory germ cell tumours.

AFFILIATION: Department of Medical Oncology, St Bartholomew's Hospital, London, UK. jonathan.shamash@bartsandthelondon.nhs.uk

Country: England

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MEDLINETA: Br J Cancer

REFSOURCE: Br J Cancer. 2007 Oct 22;97(8):1188

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