Drug Safety

, Volume 22, Issue 5, pp 373–388 | Cite as

Comparative Tolerability of Chemotherapy Regimens for Germ Cell Cancer

Review Article

Abstract

Germ cell tumours, even at an advanced stage, represent a unique model of malignant curable disease since >80% of patients are expected to be cured after appropriate therapy: surgery and radiotherapy in early stages, and chemotherapy and surgery in advanced stages. In advanced stages, serum tumour marker levels as well as extrapulmonary (brain, liver and bone) visceral metastases are the most important prognostic factors that affect treatment modalities.

‘Gold standard’ regimens for germ cell cancer currently include etoposide plus cisplatin with (BEP) or without (EP) bleomycin. In patients with good risk disease (90% cure rate), the optimal regimen of chemotherapy should combine the best efficacy and the least toxicity. As a result of randomised trials, 3 regimens can be currently recommended: (i) 4 cycles of EP; (ii) 4 cycles of BEP (with etoposide 350 mg/m2 per cycle); or (iii) 3 cycles of BEP (with etoposide 500 mg/m2 per cycle). In patients with poor risk disease, 4 cycles of BEP (with etoposide 500 mg/m2 per cycle) allow a disappointing cure rate of 50%.

The long term toxicity of these regimens (gonadal toxicity and secondary malignancies) appears to be negligible and clearly does not challenge current standard strategies.

Keywords

Etoposide Bleomycin Germ Cell Tumour Germ Cell Cancer Nonseminomatous Germ Cell Tumour 

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Copyright information

© Adis International Limited 2000

Authors and Affiliations

  1. 1.Centre Régional de Lutte contre le Cancer Val d’AurelleMontpellier Cedex 5France
  2. 2.Centre Léon BérardLyonFrance

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