Optimal Treatment for Men with Good-Prognosis Germ Cell Tumors

Although metastatic germ cell tumors are uncommon, curing young men who have them has a large payoff. Standard-of-care combination therapy with bleomycin, etoposide, and cisplatin leads to cure rates in the mid- to upper-90% range. In an effort to moderate acute and late toxicity associated with this therapy while maintaining its efficacy, researchers in Australia and New Zealand conducted a randomized trial comparing two different regimens of these drugs:

• 3 (21-day) cycles of bleomycin (30 kU on days 1, 8, and 15), etoposide (100 mg/m² on days 1–5), and cisplatin (20 mg/m² on days 1–5)

• 4 (21-day) cycles of bleomycin (30 kU on day 1), etoposide (120 mg/m² on days 1–3), and cisplatin (100 mg/m² on day 1)

Starting in 1994, the researchers intend…