Cisplatin, vincristine, methotrexate, peplomycin, etoposide (COMPE) therapy for disseminated germ cell testicular tumors.
BACKGROUND: The advent of cisplatin rendered disseminated testicular germ cell tumor an often curable malignant disease. Patients with a heavy metastatic burden, however, remain poor risks; furthermore, many patients experience nausea or other adverse events. This paper reports a trial of a cisplatin-based (COMPE) combination chemotherapy regimen based on synchronization theory. METHODS: Twenty patients with disseminated germ cell testicular tumors were treated with COMPE; any residual tumor mass was surgically resected. RESULTS: Seventeen patients (85%) achieved complete remission by chemotherapy. The actuarial overall and cause-specific 3-year survival rates were 89% and 94%, respectively. In the subset of 16 "good-risk" patients, all remain alive after a median follow-up of 43 months. Complications were quite tolerable, with nephrotoxicity in particular being extremely mild. CONCLUSION: COMPE is an effective chemotherapy regimen in patients with disseminated germ cell testicular tumors. Complications arising from this therapy are mild.