TICE Salvage Chemotherapy Treats Germ-Cell Tumors Effectively

The document reports on a study by Kondagunta and colleagues which evaluated the efficacy of TICE salvage chemotherapy in treating germ-cell tumors (GCTs). The study included 47 patients with GCTs who had unfavorable prognostic features. These patients underwent two cycles of paclitaxel plus ifosfamide, followed by three cycles of high-dose carboplatin and etoposide with peripheral-blood stem-cell support. The median dose of carboplatin was 1,635 mg/m² body surface area. Out of the 47 patients, only 34 completed all three TICE cycles. A complete response to chemotherapy was achieved by 26 patients, although 6 of them later relapsed. Four of the relapsed patients were disease-free after post-chemotherapy surgery. At a median follow-up of 40 months, 24 survivors were disease-free. The study concluded that TICE salvage chemotherapy plus stem-cell support is beneficial for patients with GCTs who have a poor prognosis with conventional carboplatin-based salvage chemotherapy. However, long-term neurotoxic and ototoxic effects were associated with carboplatin, and the authors suggest avoiding aminoglycosides after high-dose carboplatin to minimize ototoxic effects.