Gemcitabine plus vinorelbine as an effective salvage chemotherapeutic regimen in cisplatin-refractory germ cell tumor.

Germ cell tumors (GCT) are the most common malignancies among male adolescents. Approximately 5% of GCTs are of extragonadal origin. Cisplatin-based chemotherapy is the standard first-line treatment for GCT. Patients who fail to respond to first-line treatment usually have poor outcomes. High-dose chemotherapy with stem cell support, paclitaxel, gemcitabine, and oxaliplatin are reported as effective salvage treatment. We report two patients with cisplatin-refractory, metastatic, nonseminomatous, and extragonadal GCT treated successfully with gemcitabine plus vinorelbine (GV). One patient achieved good partial remission and had a five-month progression-free period. Another patient is still alive with stable disease after 4 cycles of treatment. In heavily treated, cisplatin-refractory GCT patients, GV could be considered an effective chemotherapeutic regimen.