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Accelerated BEP : a phase I trial of dose-dense BEP for intermediate and poor prognosis metastatic germ cell tumour
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Rimmer, Yvonne, Chester, John, Joffe, Johnathan, Stark, Daniel, Shamash, Jonathan, Powles, Thomas, White, J., Wason, James, Parashar, D., Armstrong, G. (Georgina), Mazhar, Danish and Williams, M. V. (2011) Accelerated BEP : a phase I trial of dose-dense BEP for intermediate and poor prognosis metastatic germ cell tumour. British Journal of Cancer, 105 (6). pp. 766-772. doi:10.1038/bjc.2011.309
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Official URL: http://dx.doi.org/10.1038/bjc.2011.309
Abstract
Background:
We used bleomycin, etoposide, cisplatin (BEP), the most effective regimen in the treatment of germ cell tumours (GCTs) and increased dose-density by using pegfilgrastim to shorten cycle length. Our aim was to assess safety and tolerability.
Methods:
Sixteen male patients with intermediate or poor prognosis metastatic GCT were treated with four cycles of 3-day BEP with G-CSF on a 14-day cycle for a planned relative dose-density of 1.5 compared with standard BEP.
Results:
Eleven intermediate and five poor prognosis patients were treated. In all, 14 of 16 patients completed the study treatment. Toxicities were comparable to previous studies using standard BEP, except for mucositis and haematological toxicity that were more severe. The overall relative dose-density for all 16 patients was mean 1.38 (range 0.72–1.5; median 1.46). Complete response was achieved after chemotherapy alone in two patients (13%) and following chemotherapy plus surgery in nine additional patients (56%). Four patients (25%) had a partial response and normalised their marker levels. At a median follow-up of 4.4 years (range 2.1–6.8) the estimated 5-year progression-free survival probability is 81% (95% CI 64–100%).
Conclusion:
Accelerated BEP is tolerable without major additional toxicity. A randomised controlled trial will be required to obtain comparative efficacy data.
| Item Type: | Journal Article | ||||||||||
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| Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Cancer -- Chemotherapy, Bleomycin | ||||||||||
| Journal or Publication Title: | British Journal of Cancer | ||||||||||
| Publisher: | Nature Publishing Group | ||||||||||
| ISSN: | 0007-0920 | ||||||||||
| Official Date: | 6 September 2011 | ||||||||||
| Dates: |
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| Volume: | 105 | ||||||||||
| Number: | 6 | ||||||||||
| Number of Pages: | 7 | ||||||||||
| Page Range: | pp. 766-772 | ||||||||||
| DOI: | 10.1038/bjc.2011.309 | ||||||||||
| Status: | Peer Reviewed | ||||||||||
| Publication Status: | Published | ||||||||||
| Access rights to Published version: | Open Access | ||||||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) |
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