Chemotherapy of disseminated germ cell tumors

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

The treatment of patients with germ cell neoplasms has improved dramatically during the last 10 years. Combination chemotherapy with cisplatin + vinblastine + bleomycin (PVB) was initiated at Indiana University in 1974. In this original study 28 of 47 patients (60%) with disseminated testicular tumors are currently alive, with a minimal follow-up of 10 years. Our next PVB study demonstrated that the vinblastine dosage could be reduced 25% (0.4 mg/kg to 0.3 mg/kg), thereby significantly reducing toxicity, without compromising the cure rate. Our third generation study confirmed the fact that maintenance therapy was not necessary, and that optimal cure rates could be achieved with merely 12 weeks of PVB induction. Overall, with follow-up of 5 to 10 years, 202 of 272 patients (74%) with disseminated testicular cancer currently are alive on these three PVB protocols. Because of the success of salvage chemotherapy, demonstrating that approximately 25% of patients not curable by PVB achieved durable complete remissions (CRs) with cisplatin + VP-16 combination chemotherapy, our next study compared PVB to cisplatin + VP-16 + bleomycin (PVP16B) as initial chemotherapy for disseminated testicular cancer. This study demonstrated that the two induction regimens produced equivalent CR rates, but that PVP16B was the preferable induction regimen because of a statistically significant reduction in neuromuscular toxicity. Our current studies will evaluate whether three courses (9 weeks) of PVP16B compared to the standard four courses of PVP16B (12 weeks) will achieve similar cure rates in minimal moderate disseminated disease. In advanced disease presentations, we are comparing standard PVP16B to double-dose cisplatin (40 mg/M2 x 5) + VP-16 + bleomycin.

Original languageEnglish
Pages (from-to)570-573
Number of pages4
JournalCancer
Volume60
Issue number3 SUPPL.
StatePublished - 1987

Fingerprint

Germ Cell and Embryonal Neoplasms
Bleomycin
Etoposide
Cisplatin
Drug Therapy
Testicular Neoplasms
Vinblastine
Combination Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Chemotherapy of disseminated germ cell tumors. / Einhorn, Lawrence.

In: Cancer, Vol. 60, No. 3 SUPPL., 1987, p. 570-573.

Research output: Contribution to journalArticle

Einhorn, L 1987, 'Chemotherapy of disseminated germ cell tumors', Cancer, vol. 60, no. 3 SUPPL., pp. 570-573.
Einhorn, Lawrence. / Chemotherapy of disseminated germ cell tumors. In: Cancer. 1987 ; Vol. 60, No. 3 SUPPL. pp. 570-573.
@article{47a875110ffa4c88838ae2315b7bfd85,
title = "Chemotherapy of disseminated germ cell tumors",
abstract = "The treatment of patients with germ cell neoplasms has improved dramatically during the last 10 years. Combination chemotherapy with cisplatin + vinblastine + bleomycin (PVB) was initiated at Indiana University in 1974. In this original study 28 of 47 patients (60{\%}) with disseminated testicular tumors are currently alive, with a minimal follow-up of 10 years. Our next PVB study demonstrated that the vinblastine dosage could be reduced 25{\%} (0.4 mg/kg to 0.3 mg/kg), thereby significantly reducing toxicity, without compromising the cure rate. Our third generation study confirmed the fact that maintenance therapy was not necessary, and that optimal cure rates could be achieved with merely 12 weeks of PVB induction. Overall, with follow-up of 5 to 10 years, 202 of 272 patients (74{\%}) with disseminated testicular cancer currently are alive on these three PVB protocols. Because of the success of salvage chemotherapy, demonstrating that approximately 25{\%} of patients not curable by PVB achieved durable complete remissions (CRs) with cisplatin + VP-16 combination chemotherapy, our next study compared PVB to cisplatin + VP-16 + bleomycin (PVP16B) as initial chemotherapy for disseminated testicular cancer. This study demonstrated that the two induction regimens produced equivalent CR rates, but that PVP16B was the preferable induction regimen because of a statistically significant reduction in neuromuscular toxicity. Our current studies will evaluate whether three courses (9 weeks) of PVP16B compared to the standard four courses of PVP16B (12 weeks) will achieve similar cure rates in minimal moderate disseminated disease. In advanced disease presentations, we are comparing standard PVP16B to double-dose cisplatin (40 mg/M2 x 5) + VP-16 + bleomycin.",
author = "Lawrence Einhorn",
year = "1987",
language = "English",
volume = "60",
pages = "570--573",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "3 SUPPL.",

}

TY - JOUR

T1 - Chemotherapy of disseminated germ cell tumors

AU - Einhorn, Lawrence

PY - 1987

Y1 - 1987

N2 - The treatment of patients with germ cell neoplasms has improved dramatically during the last 10 years. Combination chemotherapy with cisplatin + vinblastine + bleomycin (PVB) was initiated at Indiana University in 1974. In this original study 28 of 47 patients (60%) with disseminated testicular tumors are currently alive, with a minimal follow-up of 10 years. Our next PVB study demonstrated that the vinblastine dosage could be reduced 25% (0.4 mg/kg to 0.3 mg/kg), thereby significantly reducing toxicity, without compromising the cure rate. Our third generation study confirmed the fact that maintenance therapy was not necessary, and that optimal cure rates could be achieved with merely 12 weeks of PVB induction. Overall, with follow-up of 5 to 10 years, 202 of 272 patients (74%) with disseminated testicular cancer currently are alive on these three PVB protocols. Because of the success of salvage chemotherapy, demonstrating that approximately 25% of patients not curable by PVB achieved durable complete remissions (CRs) with cisplatin + VP-16 combination chemotherapy, our next study compared PVB to cisplatin + VP-16 + bleomycin (PVP16B) as initial chemotherapy for disseminated testicular cancer. This study demonstrated that the two induction regimens produced equivalent CR rates, but that PVP16B was the preferable induction regimen because of a statistically significant reduction in neuromuscular toxicity. Our current studies will evaluate whether three courses (9 weeks) of PVP16B compared to the standard four courses of PVP16B (12 weeks) will achieve similar cure rates in minimal moderate disseminated disease. In advanced disease presentations, we are comparing standard PVP16B to double-dose cisplatin (40 mg/M2 x 5) + VP-16 + bleomycin.

AB - The treatment of patients with germ cell neoplasms has improved dramatically during the last 10 years. Combination chemotherapy with cisplatin + vinblastine + bleomycin (PVB) was initiated at Indiana University in 1974. In this original study 28 of 47 patients (60%) with disseminated testicular tumors are currently alive, with a minimal follow-up of 10 years. Our next PVB study demonstrated that the vinblastine dosage could be reduced 25% (0.4 mg/kg to 0.3 mg/kg), thereby significantly reducing toxicity, without compromising the cure rate. Our third generation study confirmed the fact that maintenance therapy was not necessary, and that optimal cure rates could be achieved with merely 12 weeks of PVB induction. Overall, with follow-up of 5 to 10 years, 202 of 272 patients (74%) with disseminated testicular cancer currently are alive on these three PVB protocols. Because of the success of salvage chemotherapy, demonstrating that approximately 25% of patients not curable by PVB achieved durable complete remissions (CRs) with cisplatin + VP-16 combination chemotherapy, our next study compared PVB to cisplatin + VP-16 + bleomycin (PVP16B) as initial chemotherapy for disseminated testicular cancer. This study demonstrated that the two induction regimens produced equivalent CR rates, but that PVP16B was the preferable induction regimen because of a statistically significant reduction in neuromuscular toxicity. Our current studies will evaluate whether three courses (9 weeks) of PVP16B compared to the standard four courses of PVP16B (12 weeks) will achieve similar cure rates in minimal moderate disseminated disease. In advanced disease presentations, we are comparing standard PVP16B to double-dose cisplatin (40 mg/M2 x 5) + VP-16 + bleomycin.

UR - http://www.scopus.com/inward/record.url?scp=0023277327&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023277327&partnerID=8YFLogxK

M3 - Article

C2 - 2439185

AN - SCOPUS:0023277327

VL - 60

SP - 570

EP - 573

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 3 SUPPL.

ER -