Treatment of disseminated germ cell tumours with cisplatin, bleomycin and either vinblastine or etoposide
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.
Overview
Phase 3 trial of 261 men with disseminated germ cell tumours randomised to cisplatin, bleomycin and vinblastine (PVB) or cisplatin, bleomycin and etoposide (BEP).
Complete 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.
- 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.
BEP has been the backbone of curative chemotherapy for testicular cancer for nearly forty years.
- Small trial by modern standards; later trials defined cycle number by risk group.
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