ETOPOSIDE AND CISPLATIN WITH OR WITHOUT BLEOMYCIN AS 1ST-LINE CHEMOTHERAPY FOR PATIENTS WITH SMALL-VOLUME METASTASES OF TESTICULAR NONSEMINOMA

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  • 1 January 1985
    • journal article
    • research article
    • Vol. 69  (5) , 483-488
Abstract
Between Dec. 1981-Sept. 1982, a phase II study of etoposide and cisplatin was carried out in 17 patients with small-volume metastases of testicular nonseminoma to see whether the toxicity associated with bleomycin could be avoided without loss of therapeutic effect. Of 16 evaluable patients followed for 13-23 mo. (median, 18.5 mo.), 4 failed to achieve complete remission and 3 had disease progression. Conversely, all 18 equivalent patients treated with bleomycin, etoposide and cisplatin between Jan. 1981-Nov. 1982 (observation time, 12-34 mo.; median, 25 mo.) achieved complete remission and have been continuously disease-free since treatment (P = 0.07). Bleomycin apparently contributes significantly to the combination chemotherapy for testicular nonseminoma and although its omission led to a marked reduction in toxicity, loss of therapeutic activity was also apparent. Prolongation of the intervals between cycles of etoposide and cislatin from 3-4 wk may significantly reduce the effectiveness of the 2-drug combination, whereas no evidence of this was seen in patients treated with bleomycin, etoposide and cisplatin.