Vinblastine (VLB), bleomycin (BLEO), cis-diamminedichloroplatinum (DDP) in disseminated extragonadal germ cell tumors. A Southwest Oncology Group Study.

Nineteen patients considered to have metastatic primary extragonadal germ cell cancer were entered on a Phase II chemotherapy study using as induction therapy a combination of vinblastine (VLB) 12 mg/m2 day 1, bleomycin (BLEO) 15 U/m2 I.V. or I.M. twice weekly, and cis-diamminedichloroplatinum (DDP) 15 mg/m2 days 1-5, with vinblastine and DDP repeated at 28-day intervals for four months. All complete or partial responders were then placed on a maintenance regimen of vinblastine 12 mg/m2 alternating monthly with actinomycin-D 1.5 mg/m2 day 29, and chlorambucil, 10 mg/m2 P.O. days 32-37. There were three complete remissions (CR's), six partial remissions (PR's), and two stable disease. The response rate (CR's mpr's) was 56%; however the mean duration of response was only two months (range, 1-8 months). Drug toxicity was significant and there was one toxic death. Unlike patients with disseminated testicular cancer, patients with primary metastatic extragonadal germ cell carcinoma appear to do less well on this particular drug regimen. Further investigation using different drug regimens seems necessary.