title: VP-16-213 and cisplatin in the treatment of patients with refractory germ cell tumors.
abstract: Twenty-two patients with progressive or relapsing germ cell tumors and one 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 weeks. Three complete remissions and one partial remission were seen in five 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 two 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 one complete responder and three patients treated after resection of a solitary recurrence. Myelosuppression was universal and two 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.
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004341:Drug Evaluation; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000556:secondary
chemical_list: D005047:Etoposide; D002945:Cisplatin