Paclitaxel, gemcitabine, oxaliplatin regimen in induction therapy of patients with relapsed and refractory germ cell tumors before high-dose chemotherapy: results of a pilot study

Purpose: to evaluate the efficacy of TGO (paclitaxel, gemcitabine, oxaliplatin) regimen as induction therapy for hematopoietic stem cells mobilization (HSC) before high-dose chemotherapy (HDCT) in patients with recurrent nonseminomatous germ cell tumors (NSGCT). Patients and methods: study enrolled relapsed and/or refractory NSGCT after frontline chemotherapy. Modified (paclitaxel 100 mg/m 2 on day 1 + gemcitabine 1000 oxaliplatin 130 1, once every 14 days) was administered filgrastim support 10 mcg/kg subcutaneous from 8 until completion leukapheresis. Maximum 3 cycles administered. After harvesting required volume CD34+ cells, HDCT initiated which consisted CE (carboplatin AUC8 1–3 etoposide 400 1–3) further HSC autologous transplantation (ASCT). Results: Five poor IGCCCG prognosis according were enrolled. All them received ifosfamide-containing initial treatment. The collected three all (100 %); four (80 %) number 1st cycle TGO. Four started phase, one patient prematurely terminated treatment due rapid progression. One who full planned demonstrated complete durable tumor regression at time data analysis (with 37 months follow-up). Conclusions: can be used collect PBSC HDCT, this approach is required.