Testicular Choriocarcinoma Medication

Updated: Apr 04, 2017
  • Author: Michael B Williams, MD, MS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Medication

Medication Summary

Metastatic pure choriocarcinoma is treated with the same multi-agent chemotherapy regimens used in nonseminomatous germ cell tumors (NSGCTs), which are discussed in a separate article (see Nonseminomatous Testicular Tumors).

Standard chemotherapy for poor-risk patients and some good-to-moderate–risk patients includes 4 cycles of BEP (ie, bleomycin, etoposide, cisplatin). Additional agents in some regimens or for salvage include vinblastine and ifosfamide.

Most case reports show a poor response to chemotherapy, and the literature offers no clear treatment guidelines. [5, 17, 20, 21, 22]

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Antineoplastic agents

Class Summary

These agents inhibit cell growth and proliferation.

Bleomycin (Blenoxane)

Composed of cytotoxic glycopeptide antibiotics, which appear to inhibit DNA synthesis, with some evidence of RNA and protein synthesis inhibition to a lesser degree. Used in the management of several neoplasms as a palliative measure; however, it is an important part of curative regimens for testicular cancer.

Etoposide (Toposar, VePesid)

Arrests cells in the G2 portion of the cell cycle and induces DNA strand breaks by interacting with DNA topoisomerase II and forming free radicals.

Cisplatin (Platinol, Platinol-AQ)

Inorganic metal complex thought to act analogously to alkylating agents. Kills cells in all stages of cell cycle and inhibits DNA biosynthesis.

Ifosfamide (Ifex)

Related to nitrogen mustards and a synthetic analog of cyclophosphamide.

Vinblastine (Alkaban-AQ, Velban)

Alkaloid derivative that causes depolymerization of microtubules important to the mitotic spindle and cytoskeleton.

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