Bevacizumab plus high-dose ifosfamide, etoposide and carboplatin (HD-ICE) as third-line salvage chemotherapy induced an unexpected dramatic response in highly platinum refractory germ-cell cancer.

摘要

Primary resistance of germ-cell cancer to cisplatinum-based chemotherapy is associated with poor therapeutic outcome. Salvage chemotherapy consists of combinations including cisplatin, carboplatin, oxaliplatin, ifosfamide, etoposide, paclitaxel or gemcitabine at standard doses . The role of high-dose chemotherapy in patients truly refractory to standard dose platinum-based combinations is still a matter of debate. Vaena et al. recently reported a better outcome of patients after one or two cycles of salvage high-dose chemotherapy as could be expected from the 'Bayer score'. In contrast, in a recent randomised trial of the European Group for Blood and Marrow Transplantation (EBMT) comparing standard conventional salvage to high-dose intensification chemotherapy, the addition of high-dose chemotherapy could not improve survival .