Testicular cancer - historical

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. Is there a regimen missing from this list? See the main testicular cancer page for current regimens.
Last updated on 2024-07-23:8 regimens on this page
8 variants on this page
 
=Adjuvant therapy for resectable disease=
==BVP==
BVP: Bleomycin, Vinblastine, Platinol (Cisplatin)
PVB: Platinol (Cisplatin), Vinblastine, Bleomycin
VBD: Vinblastine, Bleomycin, DDP (Cisplatin)
===Regimen===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Williams et al. 1987	1979-1984 	Phase 3 (E-esc)	Observation	Longer RFS
====Preceding treatment====
*Orchiectomy & RPLND
====Chemotherapy====
*Bleomycin (Blenoxane) 30 units (route not specified) once per day on days 1, 8, 15, 22
*Vinblastine (Velban) 0.15 mg/kg IV bolus once per day on days 1 & 2
*Cisplatin (Platinol) 20 mg/m2 IV over 15 to 30 minutes once per day on days 1 to 5
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 dosing details in manuscript have been reviewed by our editors EuroPMC
==VAB-6==
===Regimen===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Williams et al. 1987	1979-1984 	Phase 3 (E-esc)	Observation	Longer RFS
====Preceding treatment====
*Orchiectomy & RPLND
====Chemotherapy====
*Bleomycin (Blenoxane) 30 units IV bolus once on day 1, then 15 units/m2/day IV continuous infusion over 144 hours (total dose per cycle: 120 units)
*Cisplatin (Platinol) 120 mg/m2 IV over 60 minutes once on day 7
*Cyclophosphamide (Cytoxan) 600 mg/m2 IV bolus once on day 1
*Dactinomycin (Cosmegen) 1 mg/m2 IV bolus once on day 1
*Vinblastine (Velban) 4 mg/m2 IV bolus once on day 1
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 dosing details in manuscript have been reviewed by our editors EuroPMC
=Upfront therapy for disseminated disease=
==Bleomycin & Vinblastine==
===Regimen===
Study 	Dates of enrollment	Evidence
Peckham et al. 1979	1976-01 to 1978-03 	Non-randomized
====Chemotherapy====
*Bleomycin (Blenoxane) 30 mg/day IV continuous infusion over 120 hours, started on day 1 (total dose per cycle: 150 mg)
*Vinblastine (Velban) 15 mg/m2 IV once per day on days 1 & 2
28- to 35-day cycle for 6 cycles
===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 dosing details in manuscript have been reviewed by our editors EuroPMC
==BVP==
BVP: Bleomycin, Vinblastine, Platinol (Cisplatin)
PVB: Platinol (Cisplatin), Vinblastine, Bleomycin
===Regimen===
Study 	Dates of enrollment 	Evidence 	Comparator 	Comparative Efficacy
Einhorn & Donohue 1977 	1974 to not reported	Non-randomized 	 	
Stoter et al. 1979 	1976 to not reported	Non-randomized 	 	
Einhorn et al. 1981 	1978-1980 	Phase 3 (C) 	ABVP 	Did not meet efficacy endpoints
Garnick et al. 1983 	Not reported 	Non-randomized 	 	
Samson et al. 1984 (SWOG S7817)	1978-07 to 1981-04 	Phase 3 (E-esc)	BVP; dose de-escalated	Longer OS
Stoter et al. 1986 	1979-1983 	Phase 3 (C) 	BVP; dose de-escalated	Did not meet efficacy endpoints
Williams et al. 1987a 	1982-1984 	Phase 3 (C) 	BEP 	Did not meet primary endpoint of OS1
Wozniak et al. 1991 	1982-1986 	Phase 3 (C) 	VPV 	Did not meet co-primary endpoints of CR rate/OS
1In 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====
*Bleomycin (Blenoxane) 15 units/m2 IM or IV once per day on days 1, 4, 8, 11, 15, 18 (twice per week)
*Vinblastine (Velban) 12 mg/m2 IV once on day 1
*Cisplatin (Platinol) 120 mg/m2 IV once on day 3
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 adjuvant AC
===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 EuroPMC
# 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 EuroPMC
# 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 EuroPMC
# 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 EuroPMC
# SWOG S7817: Samson MK, Rivkin SE, Jones SE, Costanzi JJ, LoBuglio AF, Stephens RL, Gehan EA, Cummings GD. Dose-response and dose-survival advantage for high versus low-dose cisplatin combined with vinblastine and bleomycin in disseminated testicular cancer: A Southwest Oncology Group study. Cancer. 1984 Mar 1;53(5):1029-35. link to original article dosing details in manuscript have been reviewed by our editors EuroPMC
# 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 EuroPMC
# 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 dosing details in manuscript have been reviewed by our editors EuroPMC
# 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 dosing details in manuscript have been reviewed by our editors EuroPMC
==Chlorambucil, Dactinomycin, Methotrexate==
===Regimen===
Study 	Dates of enrollment	Evidence
Li et al. 1960	1958-1959 	Non-randomized
Note: this is likely the first trial of combination chemotherapy in solid tumors.
====Chemotherapy====
*Chlorambucil (Leukeran) 10 mg PO once per day on days 1 to 25
*Dactinomycin (Cosmegen) 0.5 mg IV once per day on days 3 to 7, 12 to 16, 21 to 25
*Methotrexate (MTX) 5 mg PO once per day on days 1 to 25
25-day course
===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 dosing details in manuscript have been reviewed by our editors EuroPMC
==CISCA/VB==
CISCA/VB: CISplatin, Cyclophosphamide, Adriamycin (Doxorubicin) alternating with Vinblastine & Bleomycin
===Regimen===
Study 	Dates of enrollment	Evidence 	Comparator 	Comparative Efficacy
Fizazi et al. 2002 	1987-1993 	Phase 3 (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 3 (E-esc)	BEP 	Did not meet primary endpoint of FRR
====Chemotherapy, CISCA portion (cycles 1, 3, +/-5)====
*Cisplatin (Platinol) 120 mg/m2 IV once on day 3
*Cyclophosphamide (Cytoxan) 500 mg/m2 IV once per day on days 1 & 2
*Doxorubicin (Adriamycin) 45 mg/m2 IV once per day on days 1 & 2
====Chemotherapy, VB portion (cycles 2, 4, +/-6)====
*Vinblastine (Velban) 3 mg/m2 IV once per day on days 1 to 5
*Bleomycin (Blenoxane) 30 units IV once per day on days 1 to 5
21-day cycle for 4 to 6 cycles
===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 dosing details in manuscript have been reviewed by our editors EuroPMC
# 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 dosing details in manuscript have been reviewed by our editors EuroPMC
==VAB-6==
===Regimen===
Study 	Dates of enrollment	Evidence
Vugrin et al. 1981	1978-1979 	Non-randomized (RT)
Bosl et al. 1986 	1979-1982 	Non-randomized (RT)
====Chemotherapy====
*Bleomycin (Blenoxane) as follows:
**Cycles 1 & 2: 30 units IV push once on day 1, then 20 units/m2/day IV continuous infusion over 72 hours (total dose per cycle: 90 units)
*Cisplatin (Platinol) 120 mg/m2 IV once on day 4
*Cyclophosphamide (Cytoxan) 600 mg/m2 IV once on day 1
*Dactinomycin (Cosmegen) 1 mg/m2 IV once on day 1
*Vinblastine (Velban) 4 mg/m2 IV once on day 1
28-day cycle for 3 cycles
===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 dosing details in manuscript have been reviewed by our editors EuroPMC
# 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 EuroPMC
=Subsequent lines of therapy=
==Plicamycin monotherapy==
===Regimen===
Study 	Dates of enrollment 	Evidence
Brown & Kennedy 1965	Not reported 	Non-randomized, fewer than 20 pts
Ream et al. 1968 	1964-02-01 to 1967-02-01	Non-randomized
====Chemotherapy====
*Plicamycin (Mithracin) 50 mcg/kg IV once per day on days 1 to 5
1-month cycles
===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 dosing details in manuscript have been reviewed by our editors EuroPMC
# 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 EuroPMC
Category:Historical regimens
Category:Testicular cancer regimens
Category:Disease-specific pages
Category:Male genital cancers