VAB-6 Combination Chemotherapy in Disseminated Cancer of the Testis

Abstract

Men (29) with stage III or unresectable stage II malignant germ cell tumors and no previous chemotherapy received treatments with the VAB-6 protocol [vinblastine, dactinomycin, bleomycin]. The VAB-6 regimen is a 1 yr program beginning with 3 successive inductions at 3-4 wk intervals as follows: day 1.sbd.cyclophosphamide, 600 mg/m2 of body surface area i.v., bleomycin, 30 mg i.v., dactinomycin, 1 mg/m2 i.v., and vinblastine, 4 mg/m2 i.v.; days 1 through 3.sbd.bleomycin, 20 mg/m2 by continuous infusion; and day 4.sbd.cisplatin, 120 mg/m2 i.v. Bleomycin is omitted from the 3rd induction. One month after the 3rd induction, any residual disease is resected. If the resected specimen contains malignant tissue, an additional 2 inductions are given before maintenance with vinblastine, 6 mg/m2 i.v., and dactinomycin, 1 mg/m2 i.v., every 3 wk. Of 25 patients with evaluable records, 23 achieved complete remission; 21 remain in complete remission (median follow-up, more than 16 mo.). Myelosuppression is the major toxicity. With VAB-6 response rate is high; treatment is short and better tolerated than with previous VAB protocols.