INDIANAPOLIS, July 25 --When metastatic testicular cancer progresses despite initial chemotherapy, including a cisplatin-based combination, a high-dose salvage regimen with stem-cell rescue can lead to relapse-free complete responses.

So found Lawrence H. Einhorn, M.D., of Indiana University, and colleagues. In the July 26 issue of The New England Journal of Medicine, they reported that 116 of 184 (63%) consecutively treated patients, including 40 who failed cisplatin-based therapy, had complete remissions without relapse over a median 48-months follow-up.

The total number of relapse-free remissions included 94 of 135 patients (70%) who received the regimen as second-line therapy and 22 of 49 (45%) who received it as third-line or later therapy. There were three treatment-related deaths in the entire cohort.

"Testicular tumors are potentially curable by means of high-dose chemotherapy plus hematopoietic stem-cell rescue, even when this regimen is used as third-line or later therapy or in patients with platinum-refractory disease," Dr. Einhorn and colleagues concluded.