Combination Chemotherapy in Treating Patients With Stage II or Stage III Germ Cell Tumors

NCT ID: NCT00104676

Last Updated: 2025-02-06

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

263 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-11-26

Study Completion Date

2023-02-08

Brief Summary

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RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more tumor cells.

PURPOSE: This randomized phase III trial is comparing two different combination chemotherapy regimens to see how well they work in treating patients with stage II or stage III non-seminomatous germ cell tumors.

Detailed Description

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OBJECTIVES:

* Compare progression-free survival rates of patients with poor prognosis stage II or III non-seminomatous germ cell tumors with an unfavorable decrease of tumor markers after treatment with 1 course of bleomycin, etoposide, and cisplatin followed by subsequent treatment with 3 additional courses of bleomycin, etoposide, and cisplatin OR dose-dense sequential combination chemotherapy.
* Compare overall survival of patients treated with these regimens.

OUTLINE: This is a randomized, multicenter study.

Patients receive 1 course of bleomycin, etoposide, and cisplatin (BEP). Patients with a favorable decrease of tumor markers after 1 course of BEP receive 3 additional courses of BEP. Patients with an unfavorable decrease of tumor markers after 1 course of BEP are randomized to 1 of 2 treatment arms.

* Arm I: Patients receive 3 additional courses of BEP.
* Arm II: Patients receive dose-dense sequential combination chemotherapy comprising cisplatin, etoposide, bleomycin, paclitaxel, oxaliplatin, and ifosfamide.

PROJECTED ACCRUAL: A total of 260 patients will be accrued for this study.

Conditions

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Extragonadal Germ Cell Tumor Teratoma Testicular Germ Cell Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Phase 3 trial with direct individual benefit, randomized, open-label, multicenter, parallel groups
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm I

Patients receive 4 courses of bleomycin, etoposide, and cisplatin (BEP).

Group Type ACTIVE_COMPARATOR

bleomycin sulfate

Intervention Type BIOLOGICAL

At least one course administered

cisplatin

Intervention Type DRUG

At least one course administered

etoposide

Intervention Type DRUG

At least one course administered

Arm II

Patients receive 1 course of bleomycin, etoposide, and cisplatin (BEP). Patients then receive dose-dense sequential combination chemotherapy comprising cisplatin, etoposide, bleomycin, paclitaxel, oxaliplatin, and ifosfamide.

Group Type EXPERIMENTAL

bleomycin sulfate

Intervention Type BIOLOGICAL

At least one course administered

cisplatin

Intervention Type DRUG

At least one course administered

etoposide

Intervention Type DRUG

At least one course administered

ifosfamide

Intervention Type DRUG

Given in a dose-dense sequential fashion

oxaliplatin

Intervention Type DRUG

Given in a dose-dense sequential fashion

paclitaxel

Intervention Type DRUG

Given in a dose-dense sequential fashion

Interventions

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bleomycin sulfate

At least one course administered

Intervention Type BIOLOGICAL

cisplatin

At least one course administered

Intervention Type DRUG

etoposide

At least one course administered

Intervention Type DRUG

ifosfamide

Given in a dose-dense sequential fashion

Intervention Type DRUG

oxaliplatin

Given in a dose-dense sequential fashion

Intervention Type DRUG

paclitaxel

Given in a dose-dense sequential fashion

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Diagnosis of non-seminomatous germ cell tumors (NSGCT) as evidenced by 1 of the following criteria:

* Histologically confirmed NSGCT
* Clinical evidence of disease AND high serum human chorionic gonadotropin (HCG) or alpha-fetoprotein (AFP) levels
* Clinical stage II-III disease (disseminated disease)
* Testicular, retroperitoneal, or mediastinal primary site
* Poor prognosis disease, meeting 1 of the following criteria:

* Mediastinal primary site
* Non-pulmonary visceral metastases
* One of the following lab values:

* HCG \> 50,000 UI/L
* AFP \> 10,000 ng/mL
* Lactate dehydrogenase \> 10 times upper limit of normal (ULN)

PATIENT CHARACTERISTICS:

Age

* Over 16

Performance status

* Not specified

Life expectancy

* Not specified

Hematopoietic

* Absolute granulocyte count ≥ 1,500/mm\^3
* Platelet count ≥ 100,000/mm\^3

Hepatic

* Bilirubin ≤ 1.5 times ULN

Renal

* Creatinine clearance \> 60 mL/min

Other

* No other prior malignancy except basal cell skin cancer
* No HIV positivity

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No prior chemotherapy

Endocrine therapy

* Not specified

Radiotherapy

* Not specified

Surgery

* Not specified
Minimum Eligible Age

16 Years

Maximum Eligible Age

120 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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UNICANCER

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Karim Fizazi, MD, PhD

Role: STUDY_CHAIR

Gustave Roussy, Cancer Campus, Grand Paris

Locations

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M. D. Anderson Cancer Center at University of Texas

Houston, Texas, United States

Site Status

Centre Paul Papin

Angers, , France

Site Status

Institut Bergonie

Bordeaux, , France

Site Status

C.H.U. de Brest

Brest, , France

Site Status

Centre Regional Francois Baclesse

Caen, , France

Site Status

CHU de Grenoble - Hopital de la Tronche

Grenoble, , France

Site Status

Centre Oscar Lambret

Lille, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes

Marseille, , France

Site Status

Hopital Notre-Dame de Bon Secours

Metz, , France

Site Status

Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle

Montpellier, , France

Site Status

Centre Antoine Lacassagne

Nice, , France

Site Status

Hopital Europeen Georges Pompidou

Paris, , France

Site Status

Hopital Tenon

Paris, , France

Site Status

Institut Jean Godinot

Reims, , France

Site Status

Centre Eugene Marquis

Rennes, , France

Site Status

Centre Hospitalier de Rodez

Rodez, , France

Site Status

Centre Henri Becquerel

Rouen, , France

Site Status

CRLCC Nantes - Atlantique

Saint-Herblain, , France

Site Status

Institut Claudius Regaud

Toulouse, , France

Site Status

Centre Hospitalier Universitaire Bretonneau de Tours

Tours, , France

Site Status

Centre Alexis Vautrin

Vandœuvre-lès-Nancy, , France

Site Status

Institut Gustave Roussy

Villejuif, , France

Site Status

National Cancer Institute - Bratislava

Bratislava, , Slovakia

Site Status

Countries

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United States France Slovakia

References

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Fizazi K, Le Teuff G, Flechon A, Pagliaro L, Mardiak J, Geoffrois L, Laguerre B, Chevreau C, Delva R, Rolland F, Theodore C, Roubaud G, Gravis G, Eymard JC, Cancel M, Juzyna B, Reckova M, Naoun N, Logothetis C, Culine S. Personalized Chemotherapy on the Basis of Tumor Marker Decline in Poor-Prognosis Germ-Cell Tumors: Updated Analysis of the GETUG-13 Phase III Trial. J Clin Oncol. 2024 Oct;42(28):3270-3276. doi: 10.1200/JCO.23.01960. Epub 2024 Aug 21.

Reference Type DERIVED
PMID: 39167741 (View on PubMed)

Fizazi K, Pagliaro L, Laplanche A, Flechon A, Mardiak J, Geoffrois L, Kerbrat P, Chevreau C, Delva R, Rolland F, Theodore C, Roubaud G, Gravis G, Eymard JC, Malhaire JP, Linassier C, Habibian M, Martin AL, Journeau F, Reckova M, Logothetis C, Culine S. Personalised chemotherapy based on tumour marker decline in poor prognosis germ-cell tumours (GETUG 13): a phase 3, multicentre, randomised trial. Lancet Oncol. 2014 Dec;15(13):1442-1450. doi: 10.1016/S1470-2045(14)70490-5. Epub 2014 Nov 13.

Reference Type DERIVED
PMID: 25456363 (View on PubMed)

Other Identifiers

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FRE-FNCLCC-GETUG-13/0206

Identifier Type: OTHER

Identifier Source: secondary_id

2005-001072-13

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

GETUG 13

Identifier Type: -

Identifier Source: org_study_id

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