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High‐risk germ cell tumors in men high response rate and severe toxicity with cisplatin, vinblastine, bleomycin, and etoposide
Author(s) -
Blayney Douglas W.,
Goldberg David A.,
Leong Lucille A.,
Margolin Kim A.,
Burke Jerome S.,
Doroshow James H.
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930401)71:7<2351::aid-cncr2820710729>3.0.co;2-h
Subject(s) - bleomycin , etoposide , vinblastine , medicine , cisplatin , germ cell tumors , toxicity , oncology , cancer research , chemotherapy
Background . In an attempt to improve the complete remission and cure rate of advanced, bulky, high‐risk germ cell cancer in men, a “high‐dose” cisplatin, vinblastine, bleomycin, and etoposide (PVeBV) regimen was introduced. Methods . Ten men with biopsy‐proven germ cell tumors who had one or more poor prognostic features were treated with PVeBV. Results . Six of the 10 had complete remissions and are long‐term survivors. The most devastating toxicity, which resulted in the death of three patients, was progressive respiratory failure. It was postulated that renal tubular injury prolonged the renal clearance of bleomycin, intensifying the patient's pulmonary exposure to this drug and increased the susceptibility to pulmonary injury at lower than expected cumulative doses of bleomycin. Conclusions . Modifications of the regimen to reduce toxicity without diminishing the efficacy should be considered before PVeBV is adopted for general use.