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Accelerated BEP: A phase I trial of dose-dense BEP for intermediate and poor prognosis metastatic germ cell tumour

Lookup NU author(s): Professor James WasonORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).


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. © 2011 Cancer Research UK All rights reserved.

Publication metadata

Author(s): Rimmer Y, Chester J, Joffe J, Stark D, Shamash J, Powles T, White J, Wason J, Parashar D, Armstrong G, Mazhar D, Williams MV

Publication type: Article

Publication status: Published

Journal: British Journal of Cancer

Year: 2011

Volume: 105

Issue: 6

Pages: 766-772

Print publication date: 06/09/2011

Online publication date: 16/08/2011

Date deposited: 31/01/2018

ISSN (print): 0007-0920

ISSN (electronic): 1532-1827

Publisher: Nature Publishing Group


DOI: 10.1038/bjc.2011.309

PubMed id: 21847130


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