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Serum tumor marker decline is an early predictor of treatment outcome in germ cell tumor patients treated with cisplatin and ifosfamide salvage chemotherapy

✍ Scribed by Barbara A. Murphy; Robert J. Motzer; Madhu Mazumdar; Vaia Vlamis; Jerome Nisselbaum; Dean Bajorin; George J. Bosl


Publisher
John Wiley and Sons
Year
1994
Tongue
English
Weight
655 KB
Volume
73
Category
Article
ISSN
0008-543X

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✦ Synopsis


Background. Serum tumor marker regression (alpha-fetoprotein [AFP] and human chorionic gonadotrophin (hCG]) was studied in patients treated with ifosfamide-based chemotherapy for cisplatin-resistant germ cell tumors (GCT) to investigate the role of marker regression as a predictor of treatment outcome.

Methods. Fifty-four patients treated with cisplatin and ifosfamide-containing therapy were the subject of this retrospective analysis. The serum tumor marker half-life (T%) for the first two cycles of therapy was calculated for each patient using all marker values Day 7 through the end of the second treatment cycle. A calculated for hCG of less than or equal to 3 days or a calculated T% for AFP of less than or equal to 7 days was defined as appropriate marker regression; any T% greater than these values was considered prolonged. A variable designated "marker decline" was defined to indicate whether the serum tumor marker half-life of AFP and/or hCG was satisfactory or unsatisfactory for each individual patient. Both univariate and multivariate analyses were conducted to investigate "marker decline" as a predictor for response, event-free survival (time to death or relapse), and overall survival.

Results. Satisfactory marker decline predicted an improved event-free survival and overall survival. The median event-free survival for patients with an unsatisfac-~