VP-16-213 salvage therapy for refractory germinal neoplasms

Thirty-three patients with advanced refractory germinal neoplasms were treated with VP-16-213 alone or in combination with cis-platinum, bleomycin, and frequently Adriamycin. All had prior chemotherapy, which in most was extensive. There were 14 complete and 15 partial remissions. Five of the patients with partial remission were rendered disease free by resection of residual tumor. Eleven remain disease free from 6+--23+ months. Toxicity was considerable. One-third were hospitalized for fever and granulocytopenia and four had life-threatening thrombocytopenia. There was one drug-related death. VP-16 is an active drug in germinal neoplasms. It appears to be an important component of "salvage" regimens for refractory patients, but severe toxicity may ensue.