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GAMEC chemotherapy improved OS in germ-cell tumors, brain metastases
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More patients with germ-cell tumors and brain metastases who were treated with GAMEC chemotherapy achieved 3-year OS than those treated with chemotherapy before GAMEC, according to results of a prospective study.
Researchers sought to evaluate outcomes with GAMEC chemotherapy — consisting of 14 days of cisplatin, high-dose methotrexate, etoposide and actinomycin-D with filgrastim (Neupogen, Amgen) support — after the end of the routine use of cranial irradiation.
The analysis included 39 patients with germ-cell tumors and concurrent brain metastases who relapsed on cisplatin-based chemotherapy and were treated before and after the advent of GAMEC chemotherapy.
OS served as the primary endpoint.
Overall, 38% of the study population achieved 3-year survival, and median OS was 10.6 months (range, 5.5 months to not evaluable).
Sixty-nine percent of patients with brain metastases at initial diagnosis achieved 3-year OS vs. 21% of those who developed metastases after initial chemotherapy. No patient who developed metastases during chemotherapy survived for 3 years.
Patients with brain metastases at diagnosis had not yet reached a median OS (range, 7.4 months to not evaluable) at the time of the analysis. Median OS among patients who developed metastases after initial chemotherapy was 6.2 months (range, 2.1-15.3), and it was 2.7 months (range, 0.6 to not evaluable) among those who developed metastases during chemotherapy.
More patients who received GAMEC chemotherapy achieved 3-year survival than those who received chemotherapy before the advent of GAMEC (56% vs. 27%).
“The prognosis for patients with germ-cell tumors and brain metastases seems less bleak than previously thought,” the researchers wrote. “It is possible to achieve long-term survival with chemotherapy alone.”
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.
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