Evaluation of long-term results of a modified VAB-6 chemotherapy regimen in a cohort of good-risk metastatic non seminomatous germ-cell tumors.
From 1984 to 1988, we conducted at Institut Gustave-Roussy a phase II trial with a modified VAB-6 (mVAB-6) chemotherapy regimen in 50 patients with good prognosis metastatic non seminomatous germ-cell tumors, including 27 patients (54%) with retroperitoneal lymph nodes only. The mVAB-6 combination consisted of vinblastine 4 mg/m2/day at d1, of actinomycin D1 mg/m2/day at d1, of cyclophosphamide 600 mg/m2/day at d1, of cisplatin 120 mg/m2/day at d1 and of bleomycin 20 mg/day from d1 to d3. Four cycles of mVAB-6 were delivered every 4 weeks. A complete response was observed in 46 patients (92%). The other 4 patients achieved a partial response with normal serum tumor markers. Forty-two patients (84%) remain continuously free of disease. Eight relapses subsequently occurred 3 to 60 months after the end of treatment. Overall 45 patients (90%) remain free of disease after a median follow-up of 8 years. The long-term clinical toxicity was minimal. Three patients developed secondary tumors: 2 contralateral non seminomatous germ-cell tumors and 1 pancreatic adenocarcinoma. We conclude that the mVAB-6 regimen yielded excellent results and minimal long-term toxicity in this group of patients with very good-risk metastatic tumors.
Culine
S
S
Département de médecine, Institut Gustave-Roussy, Villejuif, France.
Philippot
I
I
Farhat
F
F
Théodore
C
C
Terrier-Lacombe
M J
MJ
Droz
J P
JP
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D001761:Bleomycin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D015331:Cohort Studies; D003520:Cyclophosphamide / Q000627:therapeutic use; D003609:Dactinomycin / Q000627:therapeutic use; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D018237:Germinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000473:pathology; D011379:Prognosis; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014747:Vinblastine / Q000627:therapeutic use
D014408:Biomarkers, Tumor; D001761:Bleomycin; D003609:Dactinomycin; D014747:Vinblastine; D003520:Cyclophosphamide; D002945:Cisplatin