Outcome of patients with stage 2 or stage 3 seminoma treated with 3 cycles of cisplatin-etoposide chemotherapy (EP120): Updated data from a single center retrospective study.

Authors

null

Claudia Gardiner

University of Birmingham Medical School, Birmingham, United Kingdom

Claudia Gardiner , Paul Hutton , Mariam Jafri , Emilio Porfiri

Organizations

University of Birmingham Medical School, Birmingham, United Kingdom, University Hospital Birmingham NHS Trust, Birmingham, United Kingdom, University Hospital Birmingham, Birmingham, United Kingdom, University Hospitals Birmingham, Birmingham, United Kingdom

Research Funding

Other

Background: Metastatic seminoma is eminently treatable with platinum-based chemotherapy with either 3 cycles of BEP—bleomycin (B), etoposide (E) and cisplatin (P)—or 4 cycles of EP, achieving remission in more than 95% of the patients. However, bleomycin has a substantial toxicity profile and can cause life-threatening lung toxicity. Whether similar cure rates can be achieved without exposing patients to bleomycin is still undetermined. We describe our 19-year experience of treating patients with stage 2 or stage 3 seminoma with 3 cycles of EP chemotherapy. Methods: Patients who received 3 cycles of EP120 chemotherapy (50mg/m2 cisplatin day 1 and 2 and 120mg/m2 etoposide days 1, 2 and 3 every 3 weeks for 3 cycles) for stage 2 or stage 3 seminoma between 01/03/2000 and 31/05/2015 were identified. Data were retrospectively collected on stage, prognostic group, previous adjuvant treatment, serological and radiological response, time to relapse and subsequent management, progression-free survival (PFS) and overall survival (OS). Results: We identified 115 patients who received EP120 for seminoma and who met the inclusion criteria. Median age was 40 years (range 17-72). All patients were in the good-prognosis group. 103 patients (90%) were diagnosed with stage 2 seminoma, 12 patients (10%) with stage 3 (3 patients stage 3a and 9 stage 3b). 97 patients (84%) presented with stage 2 or 3 seminoma and 18 patients (16%) had progressed to stage 2 or 3 following adjuvant radiotherapy or adjuvant carboplatin chemotherapy for stage 1 disease. Seven patients (6%) with stage 2 seminoma relapsed after EP120 chemotherapy: 2 patients ≤3 months and 5 patients ≥ 3 months. None of the patients with stage 3 disease has relapsed so far. Of the 7 patients who relapsed, 2 received radiotherapy, 4 received TIP (paclitaxel, ifosfamide, cisplatin) chemotherapy and 1 received a combination of TIP chemotherapy and radiotherapy. All patients who relapsed after EP120 are currently in remission. Two of the 115 patients (1.7%) died whilst in remission and of unrelated causes. The 5-year PFS was 94% and the OS was 98%. Conclusions: Our data suggest that patients treated with 3 cycles of EP120 had survival rates similar to patients treated with more aggressive chemotherapy regimens.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Genitourinary (Nonprostate) Cancer: Publication Only

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Germ Cell/Testicular

Citation

J Clin Oncol 37, 2019 (suppl; abstr e16061)

DOI

10.1200/JCO.2019.37.15_suppl.e16061

Abstract #

e16061

Abstract Disclosures

Similar Abstracts