Carboplatin, etoposide, and bleomycin for patients with poor-risk germ cell tumors

Abstract

A prospective study of four cycles of carboplatin (CBDCA) + etoposide + bleomycin (EBC) was conducted in 32 previously poor‐risk nonseminomatous germ cell tumor (GCT) patients and the results compared with past studies. Patients with extragonadal (nine patients) and testicular nonseminomatous GCT with a probability of complete response (CR) < 0.5 as calculated by a mathematical model using marker values and number of metastatic sites (23 patients) were included. Nineteen patients (59%) achieved a CR and 14 complete responders (43%) remain free of disease. The overall and durable CR proportions were similar to those observed in prior poor‐risk studies at Memorial Sloan‐Kettering Cancer Center. Myelosuppression was the major toxicity. Based on the low CR proportion, EBC is no better than other standard programs for poor‐risk GCT. However, its ease of administration as an outpatient, mild renal and gastrointestinal toxicity, and efficacy comparable to cisplatin‐based chemotherapy used in prior poor‐risk trials at Memorial Sloan‐Kettering Cancer Center warrant a Phase III trial comparing CBDCA‐based and cisplatin‐based chemotherapy for good‐risk GCT patients.