Management of disseminated testicular cancer

Thirteen patients with disseminated nonseminomatous germ cell tumours of the testis were treated with a three-drug combination (vinblastine, bleomycin and cis-diamminedichloroplatinum). Of 12 patients with measurable disease, 8 had complete and 3 partial remission. One patient with a solitary metastasis failed to respond but is disease free following surgical excision. Toxicity was moderate but no drug-related deaths occurred and there were no apparent lasting side-effects. No patients with complete remission have relapsed. Ten of the 13 patients are without evidence of disease from 9 to 36 months after treatment, 6 of these for 2 years or more. One patient died after a partial remission of 16 months. One is undergoing further treatment for relapse with liver metastases and one remains in partial remission at 30 months. These results demonstrate the efficacy of this drug combination in testicular cancer.