Carboplatin AUC10 in metastatic Seminoma
(Topic: “Real world evidence (except case studies)”)
R. Eldebri 1, J. Shamash 1
(1) Barts Health NHS Trust – United Kingdom
Objective:
Carboplatin monotherapy has been evaluated as a treatment option for patients with metastatic seminoma exhibiting a good prognosis according to IGCCCG criteria. Results from a phase II study, reported in 2010, demonstrated that the treatment was both tolerable and effective. These outcomes instilled confidence in the collaborative group to recommend carboplatin as a viable management strategy.
Methods:
Data were collected on 61 patients diagnosed with good prognosis seminoma. The cohort was comprised of 46% with stage IIA/IIB disease and 54% with stage >IIB. Patients received either 3 or 4 cycles of carboplatin depending on their initial response to the first cycle. The endpoints evaluated included complete response (CR), partial response (PR), stable disease, and progressive disease (PD), alongside overall survival (OS) and progression-free survival (PFS) rates over a three-year period.
Results:
Out of the 61 patients, 20 (33%) achieved a CR following the first cycle and subsequently received 2 cycles of carboplatin, while the remaining patients received 4 cycles. At the conclusion of the treatment, 31 patients (51%) had a CR, 27 (44%) had marker-negative PR, 2 (3%) had marker-negative stable disease, and 1 patient (2%) exhibited PD. The 3-year OS was 96%, and the PFS was 93%. Notably, the patient with PD eventually progressed through BEP and died 13 months post-diagnosis. However, two other patients who initially had marker-negative SD were successfully salvaged with BEP, remaining disease-free subsequently.
Conclusions:
Carboplatin monotherapy demonstrates significant efficacy in the management of metastatic seminoma with good prognosis. The favorable survival rates, combined with the convenience and reduced acute toxicities associated with carboplatin, support its consideration as a standard treatment option in this patient population.
ABSTRACT CODE: IUC20769-89