Management of advanced metastatic germ cell tumours

Forty patients with poor prognosis germ cell tumours were treated with a combination of cisplatin 40 mg/m2 and VP-16 200 mg/m2, both given days 1-5 every 3 weeks, and bleomycin 15 mg/m2 every week. Of thirty-three previously untreated patients twenty-eight (85%) patients obtained complete remission (CR) and four (12%) patients partial remission (PR). One patient was not evaluable for response. Twenty-four patients are alive 2-32 months after completion of therapy without evidence of disease (median observation 18.5 months). Of seven patients previously treated with cisplatin, five obtained CR (71%), one PR (14%) and one patient had progressive disease. Five patients are still alive, four without evidence of disease after a median follow-up of 22 months (range 16-25 months).