Vinblastine in the management of testicular cancer

Abstract

The activity of vinblastine alone and in combination with melphalan was studied in 32 patients with metastatic testicular neoplasia of germinal origin. There was a total of 16 objective responses. Twenty-one patients received 0.4 to 0.8 mg/kg of vinblastine intravenously in 2 or 3 equal daily fractions, which was repeated at 3- to 4-week intervals. There were 4 complete and 7 partial responses, the longest being 42+ months. The combination of vinblastine, 3.5 to 4.0 mg/kg intravenously in one dose, followed in 24 to 48 hours with melphalan, 0.5 to 1.0 mg/kg in 500 ml of 5% glucose in water, was given to 11 patients. Treatment was repeated at 4- to 6-week intervals. There were 2 complete and 3 partial responses, the longest being 66+ months. There was no significant difference in the number of responses or the median duration of response between the 2 treatment groups. Partial responses were seen in all histologic groups. Complete responses were limited to embryonal carcinoma, pure or mixed with seminoma, and teratoma, pure or mixed with embryonal carcinoma, seminoma or choriocarcinoma (Groups II and IV of Dixon and Moore). Statistical analysis of survival data shows a highly significant difference (P < 0.001) between responding and nonresponding patients.