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dc.contributor.authorCafferty, FHen_US
dc.contributor.authorWhite, JDen_US
dc.contributor.authorShamash, Jen_US
dc.contributor.authorHennig, Ien_US
dc.contributor.authorStenning, SPen_US
dc.contributor.authorHuddart, RAen_US
dc.contributor.authorTE23 Trial Management Group and Collaboratorsen_US
dc.date.accessioned2020-03-04T10:16:28Z
dc.date.issued2020-03en_US
dc.identifier.citationEuropean journal of cancer (Oxford, England : 1990), 2020, 127 pp. 139 - 149en_US
dc.identifier.issn1879-0852en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3525
dc.identifier.eissn1879-0852en_US
dc.identifier.doi10.1016/j.ejca.2019.12.028en_US
dc.description.abstractBACKGROUND:Up to 50% of men with poor prognosis, non-seminoma germ cell tumours (GCTs) die with standard BEP (bleomycin, etoposide and cisplatin) chemotherapy. An intensive regimen, CBOP/BEP (carboplatin, bleomycin, vincristine and cisplatin/BEP), met response targets in a randomised, phase II trial (74% complete response or partial response marker negative, 90% confidence interval (CI) 61%-85%). AIM:To assess long-term outcomes and late toxicity associated with CBOP/BEP. METHODS:Patients with poor prognosis extracranial GCT were randomised to 4xBEP or CBOP/BEP (2xCBOP, 2xBO, 3xBEP with 15,000iu of bleomycin). Low-dose, stabilising chemotherapy before entry was permitted. Response rates (primary outcome) were reported previously. Here, we report secondary outcomes: progression-free survival (PFS), overall survival (OS) and late toxicity. Prognostic factors and the impact of marker decline are assessed in exploratory analysis. RESULTS:Eighty-nine patients (43 CBOP/BEP) were randomised. After median 63 months follow-up, 3-year PFS is 55.7% (95% CI: 39.7%, 69.0%) for CBOP/BEP and 38.7% (95% CI: 24.7%, 52.4%) for BEP (hazard ratio [HR]: 0.59 (0.33, 1.06), p = 0.079). Three-year OS is 65.0% (48.8%, 77.2%) and 58.5% (43.0%, 71.2%), respectively (HR: 0.79 (0.41, 1.52), p = 0.49). Twelve-month toxicity was affected by subsequent treatments, with no clear differences between arms. Stabilising chemotherapy was associated with poorer PFS (HR: 2.09 (1.14, 3.81), p = 0.017), whereas unfavourable marker decline, in 60 (70%) patients, was not. CONCLUSION:Although not powered for PFS, results for CBOP/BEP are promising. Impact on OS was less clear (and will be affected by subsequent therapy). Further study in an international phase III trial is warranted. TRIAL REGISTRATION:ISRCTN 53643604.en_US
dc.formatPrint-Electronicen_US
dc.format.extent139 - 149en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.subjectTE23 Trial Management Group and Collaboratorsen_US
dc.titleLong-term outcomes with intensive induction chemotherapy (carboplatin, bleomycin, vincristine and cisplatin/bleomycin, etoposide and cisplatin) and standard bleomycin, etoposide and cisplatin in poor prognosis germ cell tumours: A randomised phase II trial (ISRCTN53643604).en_US
dc.typeJournal Article
dcterms.dateAccepted2019-12-21en_US
rioxxterms.versionofrecord10.1016/j.ejca.2019.12.028en_US
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0en_US
rioxxterms.licenseref.startdate2020-03en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfEuropean journal of cancer (Oxford, England : 1990)en_US
pubs.notesNo embargoen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.publication-statusPublisheden_US
pubs.volume127en_US
pubs.embargo.termsNo embargoen_US
icr.researchteamClinical Academic Radiotherapy (Huddart)en_US
dc.contributor.icrauthorHuddart, Roberten_US


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