Alternating cycles of PVB and BEP in the treatment of patients with advanced seminoma

Eur J Cancer. 1991;27(11):1376-9. doi: 10.1016/0277-5379(91)90013-4.

Abstract

33 patients (median age 39 years) with advanced seminoma were treated with 4 courses of alternating cisplatin-containing chemotherapy PVB/BEP (cisplatin, vinblastine and bleomycin; bleomycin, etoposide and cisplatin). Patients were classified as stage IIC (n = 7), IID (n = 9), III (n = 13) and IV (n = 4). 8 had had prior radiotherapy; 9 had an elevated beta human chorionic gonadotropin (beta HCG). 30 patients were evaluable for response and 33 for toxicity. During chemotherapy 3 patients died, 1 due to malignant disease, another due to a cardiac arrest, and 1 patient of a bleomycin pneumonitis. 13 (43%) had a complete remission and 17 (57%) had a clinical partial remission (residual radiographic mass). At a median follow-up of 28 months (range 16-88), 3 patients relapsed, 6-8 months after entry. After completion of therapy there were 2 deaths, 1 due to bleomycin pneumonitis and 1 neither tumour nor treatment related. 26 of 33 (79%) patients achieved a continuously disease-free status. Leucocytopenia and thrombocytopenia of WHO grade 3/4 occurred in, respectively, 32/33 (97%) and 20/33 (61%) of the patients. This study shows that alternating PVB/BEP in this group yields comparable response rates with non-alternating schedules but at the expense of considerable toxicity.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Biomarkers, Tumor / blood
  • Bleomycin / administration & dosage
  • Cisplatin / administration & dosage
  • Dysgerminoma / drug therapy*
  • Dysgerminoma / enzymology
  • Etoposide / administration & dosage
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Leukopenia / chemically induced
  • Male
  • Middle Aged
  • Thrombocytopenia / chemically induced
  • Vinblastine / administration & dosage

Substances

  • Biomarkers, Tumor
  • Bleomycin
  • Vinblastine
  • Etoposide
  • L-Lactate Dehydrogenase
  • Cisplatin

Supplementary concepts

  • BEP protocol
  • PVB protocol