Third-line chemotherapy of resistant advanced testicular cancer

The efficacy of combined chemotherapy of Vepesid + Holoxan +/- Adriblastin as third-choice was studied in advanced testicular cancer patients refractory to or recurrent after first- and second-line cytostatic therapy. Between September 1981 and January 1988 49 evaluable patients were treated with Vepesid (VP-16213 - 100 mg/m2 days 1-5), Holoxan (40 mg/kg days 1-5), hydration, urine alkylation + Uromitexan +/- Adriblastin (40 mg/m2 day 1). The single dose of Uromitexan was 20% of the daily dose of Holoxan, and the patients received it i.v. just prior to Holoxan administration (hr 0), then 4 and 8 hrs later. Two patients got into CR and 10 to PR. The rate of remission was 24.48%. The most severe side effect was leukopenia. The elevation of CN and Se creatinine was transient and mild. In those cases where Holoxan was not included in the first or second-line regimens, when combined with Vepesid and Adriblastin as third-choice therapy one could achieve further improvement. In case of CR the prolongation of life is also noteworthy.