BACKGROUNDOnly 20–30% of patients with refractory or recurrent germ cell tumors (GCT) are cured by salvage chemotherapy. Irinotecan, a new derivative of camptothecin, is a potent anticancer agent against a variety of solid cancers. The current pilot study investigated the efficacy of salvage chemotherapy with irinotecan in combination with cisplatin (CDDP) or nedaplatin (NDP), a derivative of cisplatin, for GCT.METHODSThe combination chemotherapy consisted of 100–150 mg/m2 irinotecan on Days 1 and 15 or 200–300 mg/m2 on Day 1 in combination with 20 mg/m2 CDDP on Days 1–5 or 100 mg/m2 NDP on Day 1 every 4 weeks. Patients with refractory GCT, ranging in age from 17 to 43 years, received 2–11 cycles of the combination chemotherapy. The median duration of follow‐up is 28 months (8–140 months).RESULTSTwenty patients entered this study, 18 of whom were assessed for response and toxicity. The response rate was 50 % (two complete responses and seven partial responses). Nine patients remain alive without disease. However, six patients died of the disease and one patient died of a brain glioma. The 5‐year survival rate was approximately 53%. Myelosuppression was the major toxicity, but was manageable.CONCLUSIONSThis pilot study demonstrates that the chemotherapy with irinotecan in combination with CDDP or NDP showed significant anticancer activity for patients with refractory GCT, without serious side effects. Although this study comprised only a few patients, these findings suggest that the combination chemotherapy may be one of the options of salvage chemotherapy for patients with refractory GCT. Cancer 2002;95:1879–85. © 2002 American Cancer Society.DOI 10.1002/cncr.10918

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Expression of the c‐myc gene product in urinary bladder cancer was investigated by immunohistochemical staining with anti‐c‐myc monoclonal antibody (mAb) MYC‐1. Positive staining was observed in the cytoplasm, but not in the nucleus in tissues fixed with 10% formalin. On the other hand, positive staining was localized in the nucleus in cryopreserved tissues. Of 34 cryopreserved specimens examined, positive staining with MYC‐1 mAb was observed in 1 of 12 (8.3%) of grade 1 (G1), 12 of 15 (80%) of G2 and 6 of 7 (86%) of G3. Positive staining with Ki‐67 mAb was observed in 2 of 12 (17%) of G1, 12 of 15 (80%) of G2, and 6 of 7 (86%) of G3. These results suggest that tumors with higher nuclear pleomorphism contain more proliferating cells.

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