Combination chemotherapy with cis-dichlorodiammineplatinum(II) in disseminated testicular cancer

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Abstract

Combination chemotherapy with cis-dichlorodiammineplatinum(II) (cis-platinum) has been used at Indiana University since August 1974. cis-Platinum (20 mg/m2 x 5 days every 3 weeks for three to four courses), vinblastine (0.4 mg/kg every 3 weeks for four courses), and bleomycin (30 units weekly for 12 weeks) were utilized as remission induction therapy until September 1976. This regimen produced 30% partial and 70% complete remission (CR) rates among 47 evaluable patients. Furthermore, an additional five patients (11%) were rendered disease-free following surgical removal of residual disease. Thirty-two (68%) of these patients remain alive, and 28 (60%) remain alive and disease-free. Twenty-six of these 28 patients have now been continuously disease-free for 2+ to 4+ years and are receiving no chemotherapy. From September 1976 to June 1978, an additional 79 patients were included in a three-arm randomized prospective study with cis-platinum, vinblastine, and bleomycin with or without Adriamycin, using different doses of vinblastine. Fifty-three patients (67%) achieved CR; an additional ten patients (13%) were rendered disease-free with surgical removal of residual localized disease. Only seven of these 63 patients (11%) have relapsed. One patient died due to a pulmonary embolus 3 months after surgical resection for residual embryonal carcinoma. Thus, 55 patients (70%) remain disease-free. Sixty-seven (85%) of these patients remain alive. Thus far, there has been no significant difference in CR rate or survival in any of the three arms. cis-Platinum, vinblastine, and bleomycin combination chemotherapy regimens consistently produce a 60%-70% CR rate; 10%-15% of the patients will be rendered disease-free following surgical removal of localized residual disease after significant chemotherapy-induced partial remission. The relapse rate remains low (10%-20%). We feel this represents a major advance in the management of disseminated testicular cancer.

Original languageEnglish (US)
Pages (from-to)1659-1662
Number of pages4
JournalCancer Treatment Reports
Volume63
Issue number9-10
StatePublished - Dec 1 1979

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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