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

A. Lindsay Frazier, Sara Stoneham, Carlos Rodriguez-Galindo, Ha Dang, Caihong Xia, Thomas A. Olson, Matthew J. Murray, James F. Amatruda, Furqan Shaikh, Farzana Pashankar, Deborah Billmire, Mark Krailo, Dan Stark, Mark F.H. Brougham, James C. Nicholson, Juliet P. Hale

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)30-37
Number of pages8
JournalEuropean Journal of Cancer
Volume98
DOIs
StatePublished - Jul 1 2018

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Germ Cell and Embryonal Neoplasms
Carboplatin
Germ Cells
Cisplatin
Disease-Free Survival
Pediatrics
Leukemia
Therapeutics
Clinical Trials
Confidence Intervals
Canada
Young Adult
Neoplasms
Databases

Keywords

  • Carboplatin
  • Cisplatin
  • Germ cell tumor
  • Testicular cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Comparison of carboplatin versus cisplatin in the treatment of paediatric extracranial malignant germ cell tumours : A report of the Malignant Germ Cell International Consortium. / Frazier, A. Lindsay; Stoneham, Sara; Rodriguez-Galindo, Carlos; Dang, Ha; Xia, Caihong; Olson, Thomas A.; Murray, Matthew J.; Amatruda, James F.; Shaikh, Furqan; Pashankar, Farzana; Billmire, Deborah; Krailo, Mark; Stark, Dan; Brougham, Mark F.H.; Nicholson, James C.; Hale, Juliet P.

In: European Journal of Cancer, Vol. 98, 01.07.2018, p. 30-37.

Research output: Contribution to journalArticle

Frazier, AL, Stoneham, S, Rodriguez-Galindo, C, Dang, H, Xia, C, Olson, TA, Murray, MJ, Amatruda, JF, Shaikh, F, Pashankar, F, Billmire, D, Krailo, M, Stark, D, Brougham, MFH, Nicholson, JC & Hale, JP 2018, 'Comparison of carboplatin versus cisplatin in the treatment of paediatric extracranial malignant germ cell tumours: A report of the Malignant Germ Cell International Consortium', European Journal of Cancer, vol. 98, pp. 30-37. https://doi.org/10.1016/j.ejca.2018.03.004
Frazier, A. Lindsay ; Stoneham, Sara ; Rodriguez-Galindo, Carlos ; Dang, Ha ; Xia, Caihong ; Olson, Thomas A. ; Murray, Matthew J. ; Amatruda, James F. ; Shaikh, Furqan ; Pashankar, Farzana ; Billmire, Deborah ; Krailo, Mark ; Stark, Dan ; Brougham, Mark F.H. ; Nicholson, James C. ; Hale, Juliet P. / Comparison of carboplatin versus cisplatin in the treatment of paediatric extracranial malignant germ cell tumours : A report of the Malignant Germ Cell International Consortium. In: European Journal of Cancer. 2018 ; Vol. 98. pp. 30-37.
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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.",
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T2 - A report of the Malignant Germ Cell International Consortium

AU - Frazier, A. Lindsay

AU - Stoneham, Sara

AU - Rodriguez-Galindo, Carlos

AU - Dang, Ha

AU - Xia, Caihong

AU - Olson, Thomas A.

AU - Murray, Matthew J.

AU - Amatruda, James F.

AU - Shaikh, Furqan

AU - Pashankar, Farzana

AU - Billmire, Deborah

AU - Krailo, Mark

AU - Stark, Dan

AU - Brougham, Mark F.H.

AU - Nicholson, James C.

AU - Hale, Juliet P.

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N2 - 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.

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