Prognostic impact of progression to induction chemotherapy and prior paclitaxel therapy in patients with germ cell tumors receiving salvage high-dose ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-03

AUTHORS

A Necchi, R Miceli, M Bregni, C Bokemeyer, L A Berger, K Oechsle, K Schumacher, E Kanfer, J H Bourhis, C Massard, D Laszlo, J Montoro, A Flechon, F Arpaci, S Secondino, P Wuchter, P Dreger, M Crysandt, N Worel, W Kruger, M Ringhoffer, A Unal, A Nagler, A Campos, A Wahlin, M Michieli, G Sucak, I Donnini, R Schots, N Ifrah, M Badoglio, M Martino, D Raggi, P Giannatempo, G Rosti, P Pedrazzoli, F Lanza

ABSTRACT

Little is known about the prognostic impact of prior paclitaxel therapy and response to induction chemotherapy defined as the regimen preceding high-dose chemotherapy (HDCT) for the salvage therapy of advanced germ cell tumors. Twenty European Society for Blood and Marrow Transplantation centers contributed data on patients treated between 2002 and 2012. Paclitaxel used in either prior lines of therapy or in induction-mobilization regimens was considered. Multivariable Cox analyses of prespecified factors were undertaken on PFS and overall survival (OS). As of October 2013, data for 324 patients had been contributed to this study. One hundred and ninety-two patients (59.3%) had received paclitaxel. Sixty-one patients (19%) had a progression to induction chemotherapy, 234 (72%) a response (29 (9%) missing or granulocyte colony-stimulating factor without chemotherapy). Both progression to induction chemotherapy and prior paclitaxel were significantly associated with shorter OS univariably (P<0.001 and P=0.032). On multivariable analysis from the model with fully available data (N=216) progression to induction was significantly prognostic for PFS and OS (P=0.003), but prior paclitaxel was not (P=0.674 and P=0.739). These results were confirmed after multiple imputation of missing data. Progression to induction chemotherapy could be demonstrated as an independent prognostic factor, in contrast to prior paclitaxel. More... »

PAGES

384-390

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/bmt.2015.300

DOI

http://dx.doi.org/10.1038/bmt.2015.300

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1013934146

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26642334


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