Cis-diamminedichloroplatinum, vinblastine, and bleomycin combination chemotherapy in disseminated testicular cancer

Fifty patients with disseminated testicular cancer were treated with a three-drug combination consisting of cis-diamminedichloroplatinum, vinblastine, and bleomycin. Three patients were considered inevaluable due to early death. This chemotherapy regimen produced 74% complete and 26% partial remissions. Furthermore, five patients with partial remission became disease-free after surgical removal of residual disease, producing an overall 85% disease-free status. Toxicity, although significant during remission induction with cis-platinum, vinblastine, and bleomycin, was usually manageable, although there were two drug-related deaths during this period. Thirty-eight of these patients remain alive and 32 remain alive and disease-free at 6 + to 30 + months. We believe this regimen represents a major advance in the management of patients with disseminated testicular cancer.

Improved radioimmunoassay of plasm cortisol

We report a simplified radioimmunoassay procedure for determination of plasma cortisol. The method offers the advantage that tracer, antibody, and assay buffer are added in a single step with the use of semi-automated equipment. Thus, critical pipetting procedures are minimized, and assay time is reduced to 4 h. No prior extraction or chromatographic purification of cortisol is required. The procedure is simple, reliable, and accurate. For either between-assay or within-assay determinations, the coefficients of variation are about 6%. Our results compare well with those obtained from a procedure that included extraction and chromatographic purification of cortisol in several plasma samples. Conditions for optimizing the assay are also discussed.