VAB-6: an effective chemotherapy regimen for patients with germ-cell tumors.

TLDR

The VAB‑6 regimen, comprising cyclophosphamide, vinblastine, bleomycin, dactinomycin, and cisplatin, was administered to 166 patients with testicular, retroperitoneal, or mediastinal germ‑cell tumors, with or without subsequent maintenance chemotherapy. The VAB‑6 protocol achieved an overall complete response rate of 78% (67% with chemotherapy alone, 11% after chemotherapy plus resection), with uniformly high responses in seminoma and 79% in testicular non‑seminomatous versus 60% in extragonadal tumors; relapse occurred in 12% of patients (21% extragonadal, 11% testicular), all within two years, and maintenance chemotherapy did not extend relapse‑free or overall survival, while toxicity was tolerable with no treatment‑related deaths or.

Abstract

One hundred sixty-six patients with germ-cell tumors (GCT) of the testis, retroperitoneum, and mediastinum were treated with cyclophosphamide, vinblastine, bleomycin, dactinomycin, and cisplatin (VAB-6), with and without maintenance chemotherapy. The overall complete response (CR) rate was 78%, 67% to chemotherapy alone, and 11% after chemotherapy and resection of viable residual cancer. The CR rate in all patients with seminoma was uniformly high, while the CR rate of patients with testicular nonseminomatous germ-cell tumors (79%) was superior to that of similar tumors of extragonadal origin (60%). The overall relapse rate was 12%, and was greater in tumors of extragonadal origin (21%) than in those of testicular origin (11%). Three relapses occurred after 2 years. Maintenance chemotherapy did not prolong either relapse-free or total survival. Toxicity was tolerable, and there were no treatment deaths. No Raynaud's phenomena have occurred, with a minimum duration since start of therapy of 36 months. VAB-6 is an effective chemotherapy regimen in patients with GCT with no treatment-related deaths and a majority of patients requiring only 3 months of treatment.