Cisplatin-based (PVB+M) chemotherapy in good-risk and poor-risk nonseminomatous germ cell tumors

Twenty-seven patients with metastatic nonseminomatous germ cell tumors were treated with Cisplatin, vinblastine, bleomycin, and low-dose methotrexate (PVB+M) combinations. Patients were divided into good-risk and poor-risk groups. All seven patients (100%) with good-risk factors achieved complete response, and all are alive disease free at a median of 70 months. In the poor-risk group, only 10 of 20 patients (50%) achieved complete response, and seven (35%) are alive disease free at a median of 58 months. Eight patients, 4 in each group, were required to undergo surgery for removal of postchemotherapy residual masses. The results confirm that Cisplatin-based chemotherapy protocols are adequate to cure most patients with good-risk factors, and newer approaches are needed for patients at poor risk.