HIGH-DOSE METHOTREXATE, VINCRISTINE AND CISPLATIN AS SALVAGE TREATMENT FOR RELAPSED NONSEMINOMATOUS GERM-CELL CANCER

Eight patients with non-seminomatous testicular cancel relapsing after primary chemotherapy were treated with salvage chemotherapy consistin g of high-dose methotrexate (12 g/m(2)), vincristine (1.2 mg/m(2) week ly for four weeks, followed after an interval of four weeks by 3 times 100 mg/m(2) cisplatin (50 mg/m(2) on day 1 and 2) every 10 days. This regimen resulted in 2 partial (PR) and 2 complete responses (CR). The two patients achieving CR remain disease-free for 43+ and 53+ months. Toxicity was mainly methotrexate-related and could be ameliorated to a large extent by leucovorin rescue. This small study shows that metho trexate, vincristine, followed by cisplatin is effective in the treatm ent of relapsed non-seminomatous testicular cancer at the cost of mana geable toxicity.