{"entity":{"id":"paper-williams-bep-vs-pvb-nejm-1987","kind":"paper","name":"Treatment of disseminated germ cell tumours with cisplatin, bleomycin and either vinblastine or etoposide","aka":[],"tldr":"Replacing vinblastine with etoposide in cisplatin-based chemotherapy for testicular cancer cured as many men with far less nerve and muscle toxicity and improved survival in advanced disease, establishing the BEP regimen used ever since.","summary":"Phase 3 trial of 261 men with disseminated germ cell tumours randomised to cisplatin, bleomycin and vinblastine (PVB) or cisplatin, bleomycin and etoposide (BEP).\n\nComplete response rates were similar (74 versus 83 percent), but BEP caused less neuromuscular toxicity, and in patients with advanced disease it gave higher disease-free and overall survival.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 1987","url":"https://doi.org/10.1056/NEJM198706043162302"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/2437455/"}],"tags":[],"related":[],"cancers":["non-seminoma"],"sections":[],"technologies":[],"targets":[],"drugs":["bleomycin","cisplatin","etoposide","vinblastine"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":1987,"doi":"10.1056/NEJM198706043162302","pmid":"2437455","authors":"Williams SD, Birch R, Einhorn LH, et al.","paperType":"rct","findings":["Disease-free status in 61 percent (PVB) vs 60 percent (BEP) overall; superior survival with BEP in advanced disease.","Substantially less neuromuscular toxicity with BEP."],"whatItMeans":"BEP has been the backbone of curative chemotherapy for testicular cancer for nearly forty years.","caveats":["Small trial by modern standards; later trials defined cycle number by risk group."],"changedPractice":true,"participants":261},"route":"/key-papers/paper-williams-bep-vs-pvb-nejm-1987/","neighbours":{"cancer":[{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"}],"drug":[{"id":"bleomycin","kind":"drug","name":"Bleomycin","route":"/drugs/bleomycin/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"vinblastine","kind":"drug","name":"Vinblastine","route":"/drugs/vinblastine/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}