Difference between revisions of "Testicular cancer - historical"
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<br>PVB: '''<u>P</u>'''latinol (Cisplatin), '''<u>V</u>'''inblastine, '''<u>B</u>'''leomycin | <br>PVB: '''<u>P</u>'''latinol (Cisplatin), '''<u>V</u>'''inblastine, '''<u>B</u>'''leomycin | ||
===Regimen {{#subobject:be9a77|Variant=1}}=== | ===Regimen {{#subobject:be9a77|Variant=1}}=== | ||
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!style="width: 25%"|Study | !style="width: 25%"|Study | ||
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
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<br>PVB: '''<u>P</u>'''latinol (Cisplatin), '''<u>V</u>'''inblastine, '''<u>B</u>'''leomycin | <br>PVB: '''<u>P</u>'''latinol (Cisplatin), '''<u>V</u>'''inblastine, '''<u>B</u>'''leomycin | ||
===Regimen {{#subobject:926d8b|Variant=1}}=== | ===Regimen {{#subobject:926d8b|Variant=1}}=== | ||
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!style="width: 20%"|Study | !style="width: 20%"|Study | ||
!style="width: 20%"|Years of enrollment | !style="width: 20%"|Years of enrollment | ||
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CISCA/VB: '''<u>CIS</u>'''platin, '''<u>C</u>'''yclophosphamide, '''<u>A</u>'''driamycin (Doxorubicin) alternating with '''<u>V</u>'''inblastine & '''<u>B</u>'''leomycin | CISCA/VB: '''<u>CIS</u>'''platin, '''<u>C</u>'''yclophosphamide, '''<u>A</u>'''driamycin (Doxorubicin) alternating with '''<u>V</u>'''inblastine & '''<u>B</u>'''leomycin | ||
===Protocol {{#subobject:926d8b|Variant=1}}=== | ===Protocol {{#subobject:926d8b|Variant=1}}=== | ||
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!style="width: 20%"|Study | !style="width: 20%"|Study | ||
!style="width: 20%"|Years of enrollment | !style="width: 20%"|Years of enrollment |
Revision as of 02:31, 26 September 2020
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Is there a regimen missing from this list? See the main testicular cancer page for current regimens.
7 regimens on this page
7 variants on this page
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Adjuvant therapy for resectable disease
BVP
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BVP: Bleomycin, Vinblastine, Platinol (Cisplatin)
PVB: Platinol (Cisplatin), Vinblastine, Bleomycin
Regimen
Study | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|
Williams et al. 1987 | Phase III (E-esc) | Observation | Superior RFS |
Preceding treatment
Chemotherapy
28-day cycle for 2 cycles
References
- Williams SD, Stablein DM, Einhorn LH, Muggia FM, Weiss RB, Donohue JP, Paulson DF, Brunner KW, Jacobs EM, Spaulding JT, DeWys WD, Crawford ED. Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer. N Engl J Med. 1987 Dec 3;317(23):1433-8. link to original article PubMed
Upfront therapy for disseminated disease
Bleomycin & Vinblastine
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Regimen
Study | Evidence |
---|---|
Peckham et al. 1979 | Non-randomized |
Chemotherapy
References
- Peckham MJ, McElwain TJ, Barrett A, Hendry WF. Combined management of malignant teratoma of the testis. Lancet. 1979 Aug 11;2(8137):267-70. lnk to original article PubMed
BVP
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BVP: Bleomycin, Vinblastine, Platinol (Cisplatin)
PVB: Platinol (Cisplatin), Vinblastine, Bleomycin
Regimen
Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Einhorn & Donohue 1977 | 1974-NR | Non-randomized | ||
Stoter et al. 1979 | 1976-NR | Non-randomized | ||
Einhorn et al. 1981 | 1978-1980 | Phase III (C) | ABVP | Did not meet efficacy endpoints |
Garnick et al. 1983 | NR | Non-randomized | ||
Stoter et al. 1986 | 1979-1983 | Phase III (C) | Dose de-escalated PVB | Did not meet efficacy endpoints |
Williams et al. 1987a | 1982-1984 | Phase III (C) | BEP | Did not meet primary endpoint of OS (*) |
Wozniak et al. 1991 | 1982-1986 | Phase III (C) | VPV | Did not meet primary endpoints of CR rate/OS |
Note: in Williams et al. 1987a, there seemed to be a survival disadvantage in the high tumor volume subgroup, but no difference was seen in the overall group.
Chemotherapy
21-day cycle for 4 cycles
Subsequent treatment
- Einhorn et al. 1981: Vinblastine maintenance versus no further treatment
- Garnick et al. 1983: Tumor-reductive surgery, then Cyclophosphamide & Doxorubicin
References
- Einhorn LH, Donohue J. Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med. 1977 Sep;87(3):293-8. link to original article PubMed
- Stoter G, Sleijfer DT, Vendrik CP, Schraffordt Koops H, Struyvenberg A, Van Oosterom AT, Brouwers TM, Pinedo HM. Combination chemotherapy with cis-diammine-dichloro-platinum, vinblastine, and bleomycin in advanced testicular non-seminoma. Lancet. 1979 May 5;1(8123):941-5. link to original article PubMed
- Einhorn LH, Williams SD, Troner M, Birch R, Greco FA. The role of maintenance therapy in disseminated testicular cancer. N Engl J Med. 1981 Sep 24;305(13):727-31. link to original article PubMed
- Garnick MB, Canellos GP, Richie JP. Treatment and surgical staging of testicular and primary extragonadal germ cell cancer. JAMA. 1983 Oct 7;250(13):1733-41. link to original article PubMed
- Stoter G, Sleyfer DT, ten Bokkel Huinink WW, Kaye SB, Jones WG, van Oosterom AT, Vendrik CP, Spaander P, de Pauw M, Sylvester R; EORTC Genitourinary Tract Cancer Cooperative Group. High-dose versus low-dose vinblastine in cisplatin-vinblastine-bleomycin combination chemotherapy of non-seminomatous testicular cancer: a randomized study of the EORTC Genitourinary Tract Cancer Cooperative Group. J Clin Oncol. 1986 Aug;4(8):1199-206. link to original article PubMed
- Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med. 1987 Jun 4;316(23):1435-40. link to original article contains verified protocol PubMed
- Wozniak AJ, Samson MK, Shah NT, Crawford ED, Ford CD, Altman SJ, Stephens RL, Natale RB, Bouroncle BA, Blumenstein BA, Cummings GD; Southwest Oncology Group. A randomized trial of cisplatin, vinblastine, and bleomycin versus vinblastine, cisplatin, and etoposide in the treatment of advanced germ cell tumors of the testis: a Southwest Oncology Group study. J Clin Oncol. 1991 Jan;9(1):70-6. link to original article PubMed
Chlorambucil, Dactinomycin, Methotrexate
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Regimen
Study | Evidence |
---|---|
Li et al. 1960 | Non-randomized |
Note: this is likely the first trial of combination chemotherapy in solid tumors.
Chemotherapy
References
- Li MC, Whitmore WF Jr, Golbey R, Grabstald H. Effects of combined drug therapy on metastatic cancer of the testis. JAMA. 1960 Nov 5;174:1291-9. link to original article PubMed
CISCA/VB
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CISCA/VB: CISplatin, Cyclophosphamide, Adriamycin (Doxorubicin) alternating with Vinblastine & Bleomycin
Protocol
Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Fizazi et al. 2002 | 1987-1993 | Phase III (C) | CISCA/VB; dose de-escalated | Did not meet primary endpoint of CR rate at 18 mo |
Culine et al. 2008 (T93MP) | 1994-2000 | Phase III (E-esc) | BEP | Did not meet primary endpoint of FRR |
Chemotherapy, CISCA portion
Chemotherapy, VB portion
References
- Fizazi K, Do KA, Wang X, Finn L, Logothetis CJ, Amato RJ. A 20% dose reduction of the original CISCA/VB regimen allows better tolerance and similar survival rate in disseminated testicular non-seminomatous germ-cell tumors: final results of a phase III randomized trial. Ann Oncol. 2002 Jan;13(1):125-34. link to original article PubMed
- T93MP: Culine S, Kramar A, Théodore C, Geoffrois L, Chevreau C, Biron P, Nguyen BB, Héron JF, Kerbrat P, Caty A, Delva R, Fargeot P, Fizazi K, Bouzy J, Droz JP; Genito-Urinary Group of the French Federation of Cancer Centers. Randomized trial comparing bleomycin/etoposide/cisplatin with alternating cisplatin/cyclophosphamide/doxorubicin and vinblastine/bleomycin regimens of chemotherapy for patients with intermediate- and poor-risk metastatic nonseminomatous germ cell tumors: Genito-Urinary Group of the French Federation of Cancer Centers Trial T93MP. J Clin Oncol. 2008 Jan 20;26(3):421-7. link to original article contains verified protocol PubMed
VAB-6
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Regimen
Study | Years of enrollment | Evidence |
---|---|---|
Vugrin et al. 1981 | 1978-1979 | Non-randomized (RT) |
Bosl et al. 1986 | 1979-1982 | Non-randomized (RT) |
Chemotherapy
- Bleomycin (Blenoxane)
- Cisplatin (Platinol)
- Cyclophosphamide (Cytoxan)
- Dactinomycin (Cosmegen)
- Vinblastine (Velban)
References
- Vugrin D, Herr HW, Whitmore WF Jr, Sogani PC, Golbey RB. VAB-6 combination chemotherapy in disseminated cancer of the testis. Ann Intern Med. 1981 Jul;95(1):59-61. link to original article PubMed
- Bosl GJ, Gluckman R, Geller NL, Golbey RB, Whitmore WF Jr, Herr H, Sogani P, Morse M, Martini N, Bains M, McCormack P. VAB-6: an effective chemotherapy regimen for patients with germ-cell tumors. J Clin Oncol. 1986 Oct;4(10):1493-9. link to original article PubMed
Subsequent lines of therapy
Plicamycin monotherapy
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Regimen
Study | Evidence |
---|---|
Brown & Kennedy 1965 | Non-randomized, <20 pts |
Ream et al. 1968 | Non-randomized |
Chemotherapy
References
- Brown JH, Kennedy BJ. Mithramycin in the treatment of disseminated testicular neoplasms. N Engl J Med. 1965 Jan 21;272:111-8. link to original article PubMed
- Ream NW, Perlia CP, Wolter J, Taylor SG 3rd. Mithramycin therapy in disseminated germinal testicular cancer. JAMA. 1968 Jun 17;204(12):1030-6. link to original article PubMed