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Eur J Cancer. 2018 Jul;98:30-37. doi: 10.1016/j.ejca.2018.03.004. Epub 2018 May 31.

Comparison of carboplatin versus cisplatin in the treatment of paediatric extracranial malignant germ cell tumours: A report of the Malignant Germ Cell International Consortium.

Author information

1
Dana Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA. Electronic address: lindsay_frazier@dfci.harvard.edu.
2
University College London Hospital Trusts, 235 Euston Road, London, NW1 2BU, UK.
3
St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
4
Children's Oncology Group, 222 East Huntington Drive, Monrovia, CA, 91016, USA; Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
5
Children's Oncology Group, 222 East Huntington Drive, Monrovia, CA, 91016, USA.
6
Children's Healthcare of Atlanta, Emory University, 1405 Clifton Road NE, Atlanta, GA, 30322, USA.
7
Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK; Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
8
University of Texas Southwestern Medical Center and Children's Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, USA.
9
Hospital for Sick Children, Haematology/Oncology, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
10
Yale University School of Medicine, LMP 2073, 333 Cedar Street, New Haven, CT, 06520, USA.
11
Riley Hospital for Children, 705 Riley Hospital Drive Indianapolis, IN, 46202, USA.
12
Department of Preventive Medicine, University of Southern California, Los Angeles, CA, 90033, USA.
13
St James's Institute of Oncology, St. James University Hospital, Beckett Street, Leeds, West Yorkshire, LS9 7TF, UK.
14
Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF, UK.
15
Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.
16
Department of Paediatric Haematology and Oncology, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle Upon Tyne, Tyne and Wear, NE1 4LP, UK.

Abstract

PURPOSE:

To compare the outcomes of paediatric and adolescent extracranial malignant germ cell tumour (GCT) patients treated with either carboplatin or cisplatin on clinical trials conducted by the Children's Oncology Group (COG) and the Children's Cancer and Leukaemia Group (CCLG).

METHODS:

The Malignant Germ Cell International Consortium (MaGIC) has created a database of the GCT clinical trials conducted since 1983 by COG (United States, Canada and Australia), which used cisplatin-based regimens, and by CCLG (United Kingdom), which used carboplatin-based regimens. Using the parametric cure model, this study compared the overall 4-year event-free survival (EFS), stratified by age, stage, site and the a-priori defined MaGIC 'risk' groups: standard risk ((SR) 1 (EFS >80%; age <11 years), SR2 (EFS >80%, age ≥ 11y) and poor risk (PR) (EFS ≤ 70%, age ≥ 11y).

RESULTS:

Cisplatin-based therapy was used in 620 patients; carboplatin was used in 163 patients. In the overall multivariate cure model, the two regimens did not differ significantly (cisplatin: 4-year EFS 86%; 95% confidence interval (CI) 83-89% versus carboplatin 4-year EFS 86%; 95% CI 79-90%; p = 0.87). No significant differences were noted in stratified analyses by site, stage, age and MaGIC risk groups: SR1 (p = 0.20), SR2 (p = 0.55) or PR (p = 0.72) patients.

CONCLUSIONS:

In these trials conducted contemporaneously, there is no significant difference in outcome observed overall, or any subset of patients, who were treated with regimens containing cisplatin versus carboplatin These results suggested sufficient equipoise to justify a randomised trial to evaluate the effectiveness of carboplatin versus cisplatin in the treatment of children, adolescents and young adults with standard risk GCT, which is currently underway.

KEYWORDS:

Carboplatin; Cisplatin; Germ cell tumor; Testicular cancer

PMID:
29859339
DOI:
10.1016/j.ejca.2018.03.004
[Indexed for MEDLINE]
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