Chemotherapy for Poor Risk Germ Cell Tumours An Independent Evaluation of the POM B/ACE Regime

Abstract

We have evaluated the 7-drug, alternating, high-dose cisplating regime for germ cell tumours, designated POMB/ACE, in 55 patients with advanced malignant teratomas and 5 patients with bulky metastatic seminomas. All of the latter and 5 of the teratomea patients had relapsed following radiotherapy, chemotherapy or both. The previously untreated teratoma patients included 13 whose tumours were extragonadal. The primary testicular tumour patients compared 16 with large and 21 with very large volume metastases according to the Medical Reserach Council criteria. POMB/ACE is effective therapy for poor risk patients with germ cell tumours (including those with the most advanced disease, i.e., hepatic and cerebral metastases) and prolonged treatment after marker normality seems unnecessary. It is a complex region with significantly toxicity and cannot be recommended for the treatment of patients with germ cell tumours who have an excellent prognosis with simpler, shorter and less toxic treatment.