Carboplatin (CBP) versus cisplatin (CP) within prognostic groups in pediatric extracranial malignant germ cell tumors (MGCTs).

Abstract

9539 Background: It is established that CBP is inferior to CP in adult MGCTs when used at AUC 5 or 400mg/m2. There are no randomised data for paediatric MGCTs, so conclusions from adult MGCTs have been generalised despite differences in site, histology and biology. A database, pooling patients from US and UK paediatric MGCT studies, was established to determine prognostic factors in paediatric MGCTs. We examined the effect of CBP and CP in identified prognostic groups. Methods: A dataset of 1110 paediatric MGCTs was created, treated 1983 to 2009. Treatment was CBP (JEB, AUC 7.9) in the UK and CP (PEB) in the US. After excluding patients with surgery only, pure germinoma or immature teratoma , 697 patients remained. The cure model was used to assess the prognostic significance of chemotherapy regimen after adjustment for patient characteristics. Results: Analysis stratified prognosis according to age (0-10 v 11+yrs) and stage (1-3 v 4) at diagnosis by site (testis: ovary: extragonadal). Outcome for CBP and CP in these prognostic groups is shown in the table. Conclusions: Interpretation of the results of this nonrandomised comparison requires caution. However, after adjustment for other prognostic factors, the risks of failure for JEB and PEB were not statistically different . This is particularly true for 0-10yrs. At AUC7.9 CBP is tolerable in paediatric patients, with potentially fewer late toxicities than CP. [Table: see text]