Vinblastine (VLB), bleomycin (BLEO), cis-diamminedichloroplatinum (DDP) in disseminated extragonadal germ cell tumors. A southwest oncology group study

✍ Scribed by Lynn G. Feun; Michael K. Samson; Ronald L. Stephens

• Publisher: John Wiley and Sons
• Year: 1980
• Tongue: English
• Weight: 698 KB
• Volume: 45
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19800515)45:10<2543::aid-cncr2820451012>3.0.co;2-h

✦ Synopsis

Nineteen patients considered to have metastatic primary extragonadal germ cell cancer were entered on a Phase I1 chemotherapy study using as induction therapy a combination of vinhlastine (VLB) 12 mg/m2 day I , bleomycin (BLEO) 15 U/m2 I.V. or I.M. twice weekly, and cis-diamminedichloroplatinum (DDP) 15 m g h 2 days 1-5, with vinblastine and DDP repeated at 28-day intervals for four months. All complete or partial responders were then placed on a maintenance regimen of vinhlastine 12 mg/m' alternating monthly with actinomycin-D 1.5 m g / d day 29, and chlorambucil, 10 mdm' P.O. days 32-37. There were three complete remissions (CR's), six partial remissions (PR's), and two stable disease. The response rate (CR's + PR's) was 56%; however, the mean duration of response was only two months (range, 1-8 months). Drug toxicity was significant and there was one toxic death. Unlike patients with disseminated testicular cancer, patients with primary metastatic extragonadal germ cell carcinoma appear to do less well on this particular drug regimen. Further investigation using different drug regimens seems necessary.

Cancer 452543-2549, 1980.

RIMAKY EXTRAGONADAL GERM CELL TUMORS are an uncommon group of neoplasms that have been the found in the anterior rnediastinum,L'~21.'"."LX."0 retroperitoneum;'" the pineal gland,':i.32 and the presacral region.42 The pathogenesis has been thought to be either the failure of some primordial germ cells to migrate completely into the ~c r o t u m ~" ~~~ or the dislocation of totipotential cells during embryogenesis.:jg In a patient with clinically normal testicles, it may be difficult to decide whether the tumor is actually extragonadal in origin or represents metastasis from an undetected or spontaneously regressed primary testicular tumor. In either case, the treatment should be the