Bleomycin, etoposide and cisplatinum (BEP) chemotherapy for metastatic germ cell tumours: Treatment outcomes at UKM medical centre, Malaysia

Muhammad Azrif, Yu Kong Leong, Nik Muhd. Aslan Abdullah, Voon Fong Kua, Fuad Ismail

Research output: Contribution to journalArticle

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Abstract

Introduction: Although bleomycin/etoposide/cisplatinum (BEP) chemotherapy is established as the standard treatment for germ cell tumours, it requires significant experience in administration and toxicity management to maintain optimal dose intensity. A retrospective review of 30 patients was conducted at UKMMC to study treatment outcomes. Methods & Materials: Patients with GCTs and treated with at least two cycles of BEP chemotherapy between January 2003 and Oct 2009 were eligible for this study. Patients received 4-6 cycles of bleomycin 30,000IU IV D1, D8 & D15 and either etoposide 100mg/m2 IV D1- D5 and cisplatin 20mg/m2 IV D1-D5 (5 day BEP regimen) or etoposide 165mg/m2 D1- D3 and cisplatin 50mg/m2 D1-3 (3 day BEP regimen) every three weeks per cycle. All patients received prophylactic granulocyte colony-stimulating factor (GCSF) from days 6 to 10 of each cycle. The overall response rates, 2 year progression-free survival and overall survival of the whole cohort were assessed. Results: Thirty patients fulfilled the inclusion criteria. Non-seminomatous GCTs comprised 93.3% of cases and gonadal and mediastinal primary sites were the most common. Sixty percent were classified as IGCCCG poor risk disease. Median follow-up was 26.6 months. The overall response rate (CR+PR) was 70%. The two year PFS and OS were 70% and 66%. There was a significant difference in terms of the overall response rate (85% vs 40%, p = 0.03) and in PFS (94.7% vs 50%, p = 0.003) between gonadal and extragonadal primary sites. Conclusion: It is possible to achieve outcomes similar to those in international clinical trials with close monitoring and good supportive care of patients undergoing BEP chemotherapy. There is a strong argument for patients with IGCCCG poor prognosis disease to be treated in specialist tertiary centres to optimize treatment outcomes.

Original languageEnglish
Pages (from-to)2467-2471
Number of pages5
JournalAsian Pacific Journal of Cancer Prevention
Volume13
Issue number6
DOIs
Publication statusPublished - 2012

Fingerprint

Germ Cell and Embryonal Neoplasms
Malaysia
Bleomycin
Etoposide
Drug Therapy
Cisplatin
Granulocyte Colony-Stimulating Factor
Disease-Free Survival
Patient Care
Clinical Trials
Survival

Keywords

  • BEP chemotherapy
  • Germ cell tumour
  • Malaysia
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Public Health, Environmental and Occupational Health
  • Epidemiology

Cite this

Bleomycin, etoposide and cisplatinum (BEP) chemotherapy for metastatic germ cell tumours : Treatment outcomes at UKM medical centre, Malaysia. / Azrif, Muhammad; Leong, Yu Kong; Abdullah, Nik Muhd. Aslan; Kua, Voon Fong; Ismail, Fuad.

In: Asian Pacific Journal of Cancer Prevention, Vol. 13, No. 6, 2012, p. 2467-2471.

Research output: Contribution to journalArticle

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