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Nonseminomatous Germ Cell Cancer of the Testis: Reducing Treatment-Related Morbidity in Patients With Disseminated Disease
1282
ONCOLOGY AND CHEMOTHERAPY
Bladder hyperthermia was achieved by pump infusion of heated water through a 3-way Foley catheter in 96 hours. Temperature varied from 39 to 44C. Radical cystectomy was performed 3 weeks after treatment. Doxorubicin produced leukopenia in 1 patient and alopecia in all 6 patients. Bladder hyperthermia produced temporary mild bladder discomfort in 2 patients. All patients had extensive necrosis of tumor on the luminal bladder surface. However, viable tumor remained at the periphery. Normal bladder mucosa remained viable in all patients. The authors conclude that this treatment is safe, well tolerated and merits further study. The finding of tumor necrosis on the bladder luminal surface suggests that the hyperthermia is not being well delivered to the depths of the tumor. D.K.M. 1 table, 9 references
Nonseminomatous Germ Cell Cancer of the Testis: Reducing Treatment-Related Morbidity in Patients With Disseminated Disease B. R. PASCHAL, H.B. Muss, F. RICHARDS, II, M. R. CooPER, D. R. WHITE, D. V. JACKSON, J. J. STUART AND C. L. SPURR, Piedmont Oncology Association (POA) and Oncology Research Center, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina Cancer, 50: 1742-1745 (Nov.) 1982 Standard therapy for disseminated or recurrent nonseminomatous germ cell cancer of the testis is generally the combination of cisplatin, vinblastine and bleomycin (PVB). Various modifications of this regimen have been developed in an effort to reduce toxicity. The modifications have been successful but only at the expense of reduction in the complete tumor response rate. The current study is a modified VAB-4 regimen, which resembles the PVB regimen in that cisplatin, vinblastine and bleomycin are given together at 3-week intervals. However, a lower dose of cisplatin is used and treatment is given for only 1 year. Fourteen patients with metastatic nonseminomatous germ cell cancer of the testis were studied. Ten patients received complete response with chemotherapy alone and 2 of 3 partial responders were converted to a complete response status with radiation and/or surgery. None of these 12 complete response patients has had a relapse of disease. No granulocytopenic fever or permanent renal insufficiency developed. The authors conclude that this modified V AB-4 regimen has a significantly lower incidence of toxicity without adversely affecting the complete response rate. D.K.M. 4 tables, 10 references
Evaluation of Pregnancy-Specific /11-Glycoprotein in Patients With Non-Seminomatous Testicular Germ Cell Tumors H.
W.
H.
A.
s.
DE BRUIJN,
A.
J.
H.
SuuRMEIJER,
D.
TH. SLEIJFER,
B. WILLEMSE AND J. Laboratories of Obstetrics and Gynaecology, and Immunochemistry, and the Departments of Internal Medicine, Pathology and Surgical Oncology, University Hospital Groningen, The Netherlands KOOPS, TH. OCKHUIZEN, P.H.
MARRINK,
which are produced by nonseminomatous germ cell tumors of the testis, have now gained an important role in following the course of the disease. Their application involves staging, monitoring chemotherapy and early detection of tumor progression. However, the sera of 10 to 30 per cent of the patients with this tumor show normal levels of AFP and HCG. In search for other parameters a variety of potential tumor-associated markers are under investigation, in particular carcinoembryonic antigen and the pregnancy-specific /31-glycoprotein (SP-1). The few reports on serum SP-1 as a tumor marker come to different conclusions with respect to the incidence of SP-1 elevations and its interrelationship with other tumor markers in patients with nonseminomatous germ cell tumors. The authors describe a clinical experience with serial evaluation of serum SP-1 in patients with advanced nonseminomatous testicular cancer compared to HCG and AFP. Serum SP-1 levels were measured serially in 94 patients with nonseminomatous germ cell tumors to evaluate its clinical significance as a tumor marker. In 12 of 80 patients (15 per cent) with active tumors serum SP-1 was found to be elevated, whereas serum HCG and AFP in the same sample were elevated in 53 and 45 per cent, respectively. Elevation of serum SP-1 levels always was associated with increased HCG levels and with AFP in 7 patients. During chemotherapy serum SP-1 and HCG disappeared when a complete remission was obtained. In contrast to HCG serum SP-1 failed to detect tumor progression in 2 patients. The authors conclude that serum HCG and AFP are superior as tumor markers to serum SP-1. W. W.H. 2 figures, 2 tables, 30 references
Primordial Germ Cell Proliferation in Fetal Testes in Mouse Strains With High and Low Incidences of Congenital Testicular Teratomas T.
NoGUCHI AND L. C. STEVENS, National Institute of Genetics, Mishima, Japan and The Jackson Laboratory, Bar Harbor, Maine
J. Natl. Cancer Inst., 69: 907-913 (Oct.) 1982 The development of genital ridges in mouse strains was compared to high and low susceptibility to teratocarcinogenesis. The number of dividing primordial germ cells was low at 12 days of gestation. The number increased sharply at 13 days and decreased precipitously by 15 days of gestation. The period of high mitotic activity closely paralleled the period of susceptibility to experimentally induced teratocarcinogenesis. Testes that had a long proliferative period had a higher incidence of teratomas than those that had a short proliferative period. A group of fetuses was identified that had markedly fewer than normal primordial germ cells. The incidence of teratomas in this group was high and nearly all growths were bilateral. G.P.M. 7 figures, 2 tables, 15 references
Flow Cytometric Analysis of R3327 Rat Prostate Adenocarcinoma Grown In Vivo and In Vitro A.
J. CLAFLIN, A. POLLACK, T. MALININ, N. L. BLOCK AND G. L. IRVIN, Departments of Surgery and Urology, University of Miami School of Medicine and Veteran's Administration Medical Center, Miami, Florida
Eur. J. Cancer Clin. Oncol., 18: 911-916 (Oct.) 1982
J. Natl. Cancer Inst., 69: 79-87 (July) 1982
The tumor-associated markers alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase,
The Dunning R3327 transplantable prostate adenocarcinoma in the Copenhagen rat is an acceptable model for the human
ONCOLOGY AND CHEMOTHERAPY
Bladder hyperthermia was achieved by pump infusion of heated water through a 3-way Foley catheter in 96 hours. Temperature varied from 39 to 44C. Radical cystectomy was performed 3 weeks after treatment. Doxorubicin produced leukopenia in 1 patient and alopecia in all 6 patients. Bladder hyperthermia produced temporary mild bladder discomfort in 2 patients. All patients had extensive necrosis of tumor on the luminal bladder surface. However, viable tumor remained at the periphery. Normal bladder mucosa remained viable in all patients. The authors conclude that this treatment is safe, well tolerated and merits further study. The finding of tumor necrosis on the bladder luminal surface suggests that the hyperthermia is not being well delivered to the depths of the tumor. D.K.M. 1 table, 9 references
Nonseminomatous Germ Cell Cancer of the Testis: Reducing Treatment-Related Morbidity in Patients With Disseminated Disease B. R. PASCHAL, H.B. Muss, F. RICHARDS, II, M. R. CooPER, D. R. WHITE, D. V. JACKSON, J. J. STUART AND C. L. SPURR, Piedmont Oncology Association (POA) and Oncology Research Center, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina Cancer, 50: 1742-1745 (Nov.) 1982 Standard therapy for disseminated or recurrent nonseminomatous germ cell cancer of the testis is generally the combination of cisplatin, vinblastine and bleomycin (PVB). Various modifications of this regimen have been developed in an effort to reduce toxicity. The modifications have been successful but only at the expense of reduction in the complete tumor response rate. The current study is a modified VAB-4 regimen, which resembles the PVB regimen in that cisplatin, vinblastine and bleomycin are given together at 3-week intervals. However, a lower dose of cisplatin is used and treatment is given for only 1 year. Fourteen patients with metastatic nonseminomatous germ cell cancer of the testis were studied. Ten patients received complete response with chemotherapy alone and 2 of 3 partial responders were converted to a complete response status with radiation and/or surgery. None of these 12 complete response patients has had a relapse of disease. No granulocytopenic fever or permanent renal insufficiency developed. The authors conclude that this modified V AB-4 regimen has a significantly lower incidence of toxicity without adversely affecting the complete response rate. D.K.M. 4 tables, 10 references
Evaluation of Pregnancy-Specific /11-Glycoprotein in Patients With Non-Seminomatous Testicular Germ Cell Tumors H.
W.
H.
A.
s.
DE BRUIJN,
A.
J.
H.
SuuRMEIJER,
D.
TH. SLEIJFER,
B. WILLEMSE AND J. Laboratories of Obstetrics and Gynaecology, and Immunochemistry, and the Departments of Internal Medicine, Pathology and Surgical Oncology, University Hospital Groningen, The Netherlands KOOPS, TH. OCKHUIZEN, P.H.
MARRINK,
which are produced by nonseminomatous germ cell tumors of the testis, have now gained an important role in following the course of the disease. Their application involves staging, monitoring chemotherapy and early detection of tumor progression. However, the sera of 10 to 30 per cent of the patients with this tumor show normal levels of AFP and HCG. In search for other parameters a variety of potential tumor-associated markers are under investigation, in particular carcinoembryonic antigen and the pregnancy-specific /31-glycoprotein (SP-1). The few reports on serum SP-1 as a tumor marker come to different conclusions with respect to the incidence of SP-1 elevations and its interrelationship with other tumor markers in patients with nonseminomatous germ cell tumors. The authors describe a clinical experience with serial evaluation of serum SP-1 in patients with advanced nonseminomatous testicular cancer compared to HCG and AFP. Serum SP-1 levels were measured serially in 94 patients with nonseminomatous germ cell tumors to evaluate its clinical significance as a tumor marker. In 12 of 80 patients (15 per cent) with active tumors serum SP-1 was found to be elevated, whereas serum HCG and AFP in the same sample were elevated in 53 and 45 per cent, respectively. Elevation of serum SP-1 levels always was associated with increased HCG levels and with AFP in 7 patients. During chemotherapy serum SP-1 and HCG disappeared when a complete remission was obtained. In contrast to HCG serum SP-1 failed to detect tumor progression in 2 patients. The authors conclude that serum HCG and AFP are superior as tumor markers to serum SP-1. W. W.H. 2 figures, 2 tables, 30 references
Primordial Germ Cell Proliferation in Fetal Testes in Mouse Strains With High and Low Incidences of Congenital Testicular Teratomas T.
NoGUCHI AND L. C. STEVENS, National Institute of Genetics, Mishima, Japan and The Jackson Laboratory, Bar Harbor, Maine
J. Natl. Cancer Inst., 69: 907-913 (Oct.) 1982 The development of genital ridges in mouse strains was compared to high and low susceptibility to teratocarcinogenesis. The number of dividing primordial germ cells was low at 12 days of gestation. The number increased sharply at 13 days and decreased precipitously by 15 days of gestation. The period of high mitotic activity closely paralleled the period of susceptibility to experimentally induced teratocarcinogenesis. Testes that had a long proliferative period had a higher incidence of teratomas than those that had a short proliferative period. A group of fetuses was identified that had markedly fewer than normal primordial germ cells. The incidence of teratomas in this group was high and nearly all growths were bilateral. G.P.M. 7 figures, 2 tables, 15 references
Flow Cytometric Analysis of R3327 Rat Prostate Adenocarcinoma Grown In Vivo and In Vitro A.
J. CLAFLIN, A. POLLACK, T. MALININ, N. L. BLOCK AND G. L. IRVIN, Departments of Surgery and Urology, University of Miami School of Medicine and Veteran's Administration Medical Center, Miami, Florida
Eur. J. Cancer Clin. Oncol., 18: 911-916 (Oct.) 1982
J. Natl. Cancer Inst., 69: 79-87 (July) 1982
The tumor-associated markers alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase,
The Dunning R3327 transplantable prostate adenocarcinoma in the Copenhagen rat is an acceptable model for the human