Phase II trial of gemcitabine in refractory germ cell tumors

Purpose: This phase II study was designed to determine the toxicity and activity of single-agent gemcitabine in heavily pretreated patients with germ cell tumors. Patients and Methods: From March 1996 through November 1997, 21 patients were enrolled onto a phase II study of gemcitabine 1,200 mg/m(2), given on days 1, 8, and 15 every 4 weeks. One patient was unassessable because he never received any gemcitabine. Thirteen of 20 patients had received three prior regimens, and 13 patients were platinum refractory (progression during or within 4 weeks of platinum treatment). There were five extragonadal cases and two patients with late relapse (relapse beyond 2 years). Results: Gemcitabine was well tolerated. Only one patient had grade 3 or 4 nanhematologic toxicity (grade 3 nausea). Six of 20 patients had grade 3 leukopenia. There were no episodes of granulocytopenic fever, and no patient required platelet transfusion. Three (15%)of 20 patients achieved an objective response, including one complete remission. Three additional patients had a minor radiographic or serologic response. Conclusion: Gemcitabine had definite activity in this heavily pretreated germ cell tumor patient population. (C) 1999 by American Society of Clinical Oncology.