Actinomycin D revisited in testicular cancer. A case report.
BACKGROUND
Between 20-30% of patients with advanced germ cell tumors relapse or fail to achieve a complete response to conventional cisplatin based chemotherapy. Ifosphamide has been used very effectively in combination with cisplatin and etoposide (VIP) or in combination with cisplatin and vinblastine (VeIP). Actinomycin D with chlorambucil and methotrexate was widely used in the 1960s with complete responses in 20% of patients and long term survival of 6-10%. There exists no information on the use of actinomycin as a salvage in cisplatin refractory patients.


RESULTS
One patient with metastatic germ cell tumor who failed chemotherapy with cisplatin and ifosphamide was successfully treated with an actinomycin D based regimen.


CONCLUSIONS
Actinomycin D is an active agent in testicular cancer and maybe used in patients refractory to platinum.
Srinivas
S
S
VA Medical Center, Stanford University, CA, USA. srinivas@icon.palo-alto.med.va.gov
Freiha
F S
FS
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D003609:Dactinomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D018237:Germinoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D013736:Testicular Neoplasms / Q000188:drug therapy*
D000903:Antibiotics, Antineoplastic; D003609:Dactinomycin