Paclitaxel, ifosfamide and cisplatin regimen is feasible for Japanese patients with advanced germ cell cancer

Koji Kawai, Jun Miyazaki, Sadamu Tsukamoto, Shiro Hinotsu, Kazunori Hattori, Toru Shimazui, Hideyuki Akaza

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Paclitaxel, ifosfamide and cisplatin (TIP) has been tested with successful results on metastatic testicular cancer in Western countries. Because paclitaxel, the key drug of this regimen, has not been approved for testicular cancer in Japan, there are no established data concerning TIP. The purpose of this study was to assess the feasibility of a TIP regimen for Japanese patients with advanced germ cell cancer. Methods: Eight patients with advanced germ cell cancer were treated with TIP that was originally reported by Motzer et al (1). The treatment was used for three refractory cases and two late relapse cases as salvage therapy and for three poor-risk cases with extra-pulmonary visceral metastases as a part of induction chemotherapy. TIP consisted of paclitaxel 175 mg/m2 by 24 h infusion on day 1, followed by ifosfamide 1.2 g/m2 infusions over 2 h and cisplatin 20 mg/ m2given over 2 h on days 2-6. Results: Five patients (62%) achieved a disease-free status after chemotherapy and surgical resection of residual tumor. Three of five patients have remained continuously free from disease progression at a median follow-up duration of 24 months and one additional patient is currently free of evidence of disease. Most patients developed grade 3 or 4 leukocytopenia and thrombocytopenia; however, they could be managed with routine supportive care. Sensory neuropathy was frequently seen, but no patient experienced over grade 3 neurotoxicity. Conclusions: TIP regimen as salvage chemotherapy is feasible for Japanese patients with advanced germ cell cancer. TIP as a part of induction chemotherapy for poor-risk patients is also feasible; however, larger and longer-term follow-up studies are needed to define the role of TIP in this setting.

Original languageEnglish
Pages (from-to)127-131
Number of pages5
JournalJapanese Journal of Clinical Oncology
Volume33
Issue number3
DOIs
Publication statusPublished - Mar 1 2003
Externally publishedYes

Fingerprint

Ifosfamide
Germ Cell and Embryonal Neoplasms
Induction Chemotherapy
Testicular Neoplasms
Paclitaxel
TP protocol
Drug Therapy
Salvage Therapy
Leukopenia
Residual Neoplasm
Cisplatin
Disease Progression
Japan
Neoplasm Metastasis
Recurrence
Lung

Keywords

  • Cisplatin
  • Ifosfamide
  • Paclitaxel
  • Testicular cancer

ASJC Scopus subject areas

  • Oncology

Cite this

Paclitaxel, ifosfamide and cisplatin regimen is feasible for Japanese patients with advanced germ cell cancer. / Kawai, Koji; Miyazaki, Jun; Tsukamoto, Sadamu; Hinotsu, Shiro; Hattori, Kazunori; Shimazui, Toru; Akaza, Hideyuki.

In: Japanese Journal of Clinical Oncology, Vol. 33, No. 3, 01.03.2003, p. 127-131.

Research output: Contribution to journalArticle

Kawai, K, Miyazaki, J, Tsukamoto, S, Hinotsu, S, Hattori, K, Shimazui, T & Akaza, H 2003, 'Paclitaxel, ifosfamide and cisplatin regimen is feasible for Japanese patients with advanced germ cell cancer', Japanese Journal of Clinical Oncology, vol. 33, no. 3, pp. 127-131. https://doi.org/10.1093/jjco/hyg029
Kawai, Koji ; Miyazaki, Jun ; Tsukamoto, Sadamu ; Hinotsu, Shiro ; Hattori, Kazunori ; Shimazui, Toru ; Akaza, Hideyuki. / Paclitaxel, ifosfamide and cisplatin regimen is feasible for Japanese patients with advanced germ cell cancer. In: Japanese Journal of Clinical Oncology. 2003 ; Vol. 33, No. 3. pp. 127-131.
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AU - Kawai, Koji

AU - Miyazaki, Jun

AU - Tsukamoto, Sadamu

AU - Hinotsu, Shiro

AU - Hattori, Kazunori

AU - Shimazui, Toru

AU - Akaza, Hideyuki

PY - 2003/3/1

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N2 - Background: Paclitaxel, ifosfamide and cisplatin (TIP) has been tested with successful results on metastatic testicular cancer in Western countries. Because paclitaxel, the key drug of this regimen, has not been approved for testicular cancer in Japan, there are no established data concerning TIP. The purpose of this study was to assess the feasibility of a TIP regimen for Japanese patients with advanced germ cell cancer. Methods: Eight patients with advanced germ cell cancer were treated with TIP that was originally reported by Motzer et al (1). The treatment was used for three refractory cases and two late relapse cases as salvage therapy and for three poor-risk cases with extra-pulmonary visceral metastases as a part of induction chemotherapy. TIP consisted of paclitaxel 175 mg/m2 by 24 h infusion on day 1, followed by ifosfamide 1.2 g/m2 infusions over 2 h and cisplatin 20 mg/ m2given over 2 h on days 2-6. Results: Five patients (62%) achieved a disease-free status after chemotherapy and surgical resection of residual tumor. Three of five patients have remained continuously free from disease progression at a median follow-up duration of 24 months and one additional patient is currently free of evidence of disease. Most patients developed grade 3 or 4 leukocytopenia and thrombocytopenia; however, they could be managed with routine supportive care. Sensory neuropathy was frequently seen, but no patient experienced over grade 3 neurotoxicity. Conclusions: TIP regimen as salvage chemotherapy is feasible for Japanese patients with advanced germ cell cancer. TIP as a part of induction chemotherapy for poor-risk patients is also feasible; however, larger and longer-term follow-up studies are needed to define the role of TIP in this setting.

AB - Background: Paclitaxel, ifosfamide and cisplatin (TIP) has been tested with successful results on metastatic testicular cancer in Western countries. Because paclitaxel, the key drug of this regimen, has not been approved for testicular cancer in Japan, there are no established data concerning TIP. The purpose of this study was to assess the feasibility of a TIP regimen for Japanese patients with advanced germ cell cancer. Methods: Eight patients with advanced germ cell cancer were treated with TIP that was originally reported by Motzer et al (1). The treatment was used for three refractory cases and two late relapse cases as salvage therapy and for three poor-risk cases with extra-pulmonary visceral metastases as a part of induction chemotherapy. TIP consisted of paclitaxel 175 mg/m2 by 24 h infusion on day 1, followed by ifosfamide 1.2 g/m2 infusions over 2 h and cisplatin 20 mg/ m2given over 2 h on days 2-6. Results: Five patients (62%) achieved a disease-free status after chemotherapy and surgical resection of residual tumor. Three of five patients have remained continuously free from disease progression at a median follow-up duration of 24 months and one additional patient is currently free of evidence of disease. Most patients developed grade 3 or 4 leukocytopenia and thrombocytopenia; however, they could be managed with routine supportive care. Sensory neuropathy was frequently seen, but no patient experienced over grade 3 neurotoxicity. Conclusions: TIP regimen as salvage chemotherapy is feasible for Japanese patients with advanced germ cell cancer. TIP as a part of induction chemotherapy for poor-risk patients is also feasible; however, larger and longer-term follow-up studies are needed to define the role of TIP in this setting.

KW - Cisplatin

KW - Ifosfamide

KW - Paclitaxel

KW - Testicular cancer

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