VP-16–213 and cisplatin in the treatment of patients with refractory germ cell tumors

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Abstract
Patients (22) with progressive or relapsing germ cell tumors and 1 patient without prior treatment received VP-16-213 (etoposide) 100 mg/m2 on days 1-5 and cisplatin 20 mg/m2 days 1-5 every 4 wk. Three complete remissions and 1 partial remission were seen in 5 patients who previously achieved a complete remission to a cisplatin-based regimen. A partial remission was observed in a previously untreated patient with widely metastatic extragonadal choriocarcinoma. No complete remissions and 2 partial remissions were seen in 14 patients who did not achieve a previous complete remission to cisplatin-based combination chemotherapy. Four patients remain free of disease, including 1 complete responder and 3 patients treated after resection of a solitary recurrence. Myelosuppression was universal and 2 very heavily pretreated patients died with leukopenia and presumed infection. VP-16-213 plus cisplatin may be an effective salvage regimen for patients relapsing after a complete remission, but is probably ineffective if the patient has not achieved a prior complete remission.