The aim of this study was assess the activity of thalidomide in patients with progressive relapsed or platinum-refractory germ-cell tumours (GCT). Between April 2002 and January 2003, 15 patients with inoperable progressive GCT were treated with escalated daily doses of 200–600 mg thalidomide. All patients had failed first-line and salvage chemotherapy with a median of 6 (range 4–12) cisplatin-based treatment cycles, 13/15 (87%) patients had received high-dose chemotherapy (HDCT) and 8/15 (53%) patients were considered platinum-refractory or absolute refractory; 8/15 (53%) patients had previously received other palliative chemotherapy regimens. No patient achieved a complete remission (CR) or partial remission (PR). However, 5/15 (33%) patients achieved serological PR and 1 additional patient had stable disease for 3 months. The median duration of remissions was 3 months (range 2–12 months) including 2 patients with a progression-free survival of 9 and 12 months. Responses occurred mainly in patients with a low tumour burden, slow disease progression and alpha-foetoprotein (AFP) elevations. Responses to thalidomide were independent from platinum-sensitivity. Toxicity was mild, with lethargy and constipation in the majority of patients. Skin rash grade II developed in 2 patients and peripheral neurotoxicity grade II/III developed in 4 patients. One responding patient died suddenly from an unknown cause. It is concluded that thalidomide shows single-agent activity in patients with heavily pre-treated GCT, AFP elevations and slowly progressive disease.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Cancer
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Testicular germ-cell cancer.N Engl J Med. 1997; 337: 242-254
- Chemotherapy for germ cell tumors relapsing after high-dose chemotherapy and stem cell support: a retrospective multicenter study of the Austrian Study Group on Urologic Oncology.Ann Oncol. 1997; 8: 1229-1234
- Analysis of salvage treatments for germ cell cancer patients who have relapsed after primary high-dose chemotherapy plus autologous stem cell support.Eur J Cancer. 2003; 39: 775-782
- Results of treatment after relapse from high-dose chemotherapy in germ cell tumors.J Clin Oncol. 2000; 18: 1181-1186
- Thalidomide: current role in the treatment of non-plasma cell malignancies.J Clin Oncol. 2004; 22: 2477-2488
- Expression of vascular endothelial growth factor in patients with testicular germ cell tumors as an indicator of metastatic disease.Cancer. 1999; 85: 1323-1330
- Marked increase of the growth factors pleiotrophin and fibroblast growth factor-2 in serum of testicular cancer patients.Ann Oncol. 2003; 14: 1525-1529
- Salvage treatment with paclitaxel, ifosfamide, and cisplatin plus high-dose carboplatin, etoposide, and thiotepa followed by autologous stem-cell rescue in patients with relapsed or refractory germ cell cancer.J Clin Oncol. 2001; 19: 81-88
National Cancer Institute. Common Toxicity Criteria v2.0 (CTC). Updated 18th August 1999. Available from http://ctep.cancer.gov.
Accepted: March 24, 2006
Received in revised form: March 20, 2006
Received: October 26, 2005
© 2006 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.