Chemotherapy of germinal tumors

Twenty-one evaluable patients with germinal tumors of the genital system were treated with a combination of vincristine, methotrexate, and melphalan. Tumor regression was obtained in three patients with seminoma of the testis, one with teratocarcinoma of the testis, two with choriocarcinoma of the testis, four with embryonal carcinoma of the testis, one with retroperitoneal seminoma, one with choriocarcinoma of unknown primary site, one with dysgerminoma of the ovary, and one with teratocarcinoma of the ovary. Because of a high incidence of toxicity and brevity of the responses in the patients with more malignant tumors, the program was changed to vincristine, methotrexate, and cyclophosphamide. Of 13 evaluable patients thus treated, one with seminoma of the testis, five with embryonal carcinoma of the testis, one with dysgerminoma of the ovary, and one with choriocarcinoma of the ovary had objective benefit. There was no improvement in toxicity or in duration of response. Four patients from the two programs currently continue in remissions longer than one year in duration.