Testicular Germ Cell Tumor Clinical Trial
Official title:
A Randomized Phase III Study of Paclitaxel, Ifosfamide and Cisplatin Versus Vinblastine, Ifosfamide and Cisplatin as Second-Line Therapy for Patients With Relapsed/Resistant Germ Cell Tumors
RATIONALE: Drugs used in chemotherapy, such as ifosfamide, cisplatin, paclitaxel, and
vinblastine, work in different ways to stop tumor cells from dividing so they stop growing
or die. It is not yet known whether ifosfamide and cisplatin are more effective when
combined with paclitaxel or vinblastine in treating germ cell tumors.
PURPOSE: This randomized phase III trial is studying paclitaxel, ifosfamide, and cisplatin
to see how well they work compared to vinblastine, ifosfamide, and cisplatin in treating men
with progressive or recurrent metastatic germ cell tumors.
OBJECTIVES:
Primary
- Compare the overall survival of men with progressive or recurrent metastatic germ cell
tumors treated with paclitaxel, ifosfamide, and cisplatin vs vinblastine, ifosfamide,
and cisplatin as second-line therapy.
Secondary
- Compare the progression-free survival of patients treated with these regimens.
- Compare the toxicity profiles of these regimens in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to prior
complete response or partial response with negative markers for at least 6 months (yes vs
no) and relapse at least 2 years after completing first-line chemotherapy for germ cell
tumors (yes vs no). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive paclitaxel IV over 24 hours on day 1 and cisplatin IV over
20-30 minutes and ifosfamide IV over 30 minutes on days 2-5. Patients also receive
filgrastim (G-CSF) subcutaneously (SC) on days 7-18 OR pegfilgrastim SC once within
24-72 hours after completion of chemotherapy.
- Arm II: Patients receive vinblastine IV on days 1 and 2 and cisplatin IV over 20-30
minutes and ifosfamide IV over 30 minutes on days 1-5. Patients also receive G-CSF SC
on days 7-18 OR pegfilgrastim as in arm I.
In both arms, treatment repeats every 21 days for 4 courses in the absence of disease
progression or unacceptable toxicity.
Patients are followed every 2 months for 2 years, every 3 months for 1 year, every 4 months
for 1 year, every 6 months for 1 year, and then annually thereafter.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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