Chemotherapy of germ cell tumors of the testis. I. Induction of remissions with vinblastine, actinomycin D, and bleomycin.

Patients with disseminated testicular carcinoma were treated with the combination of vinblastine, actinomycin D, and bleomycin in an attempt to induce remission. Of 47 patients receiving an initial adequate trial of this regimen, 34% achieved a complete or partial remission; in the 18 patients with either no prior nonsurgical treatment or treatment with actinomycin D alone, the response rate was 61%. Those who attained complete response status enjoyed significant prolongation of life compared with the nonresponders or partial responders. Responses were seen in all histologic categories and were not related to the performance status of the patient at the start of the trial, to the total dose of drug in the first mouth of therapy, or the extent of hematologic toxicity produced by the drugs. Responders had a higher incidence of stomatitis than nonresponders.