Cancer cell international · 2025
Efficacy and safety of modified bleomycin administration with EP chemotherapy in adult male patients with germ cell tumors: a retrospective study.
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Shu Ditian, Huang Riqing, Chen Meiting, Li Haifeng, An Xin, Xue Cong, Hu Anqi, Zhou Fangjian, Yao Kai, Liu Zhuowei, Shi Yanxia
Аннотация
BACKGROUND: Given the substantial inconvenience caused by weekly bleomycin administration, we initiated a study to evaluate the efficacy and toxicity of the modified bleomycin combined with EP (modified-BEP) regimen in Chinese adult male patients with germ cell tumors (GCTs).
METHODS: We conducted a retrospective analysis of 274 adult male GCT patients treated with modified-BEP at the Sun Yat-sen University Cancer Center between 2005 and 2022. The regimen involved a tri-weekly 5-day schedule with 30 IU modified bleomycin (administered on days 1, 3, and 5), 20 mg/m2 cisplatin (days 1-5), and 100 mg/m2 etoposide (days 1-5). The survival rates and safety profiles of the patients were analyzed.
RESULTS: Among the patients, 42 patients received BEP in adjuvant setting, while 232 were treated with BEP in curative setting. With a median follow-up of 41.03 months among the curative patient population, the 5-year progression-free survival (PFS) rate was 79.33%, and the 5-year overall survival (OS) rate was 86.26%. Stratified by the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic groups, the 5-year OS rates of the good, intermediate, and poor risk groups were 99.05%, 92.84%, and 55.96% (P < 0.0001), respectively. Favorable responses, including complete remission and partial response with negative tumor markers, were achieved in 91.07% of good-risk, 84.13% of intermediate-risk, and 52.63% of poor-risk patients, with a significant difference (P < 0.0001). Multivariate analysis indicated that non-seminoma, poor risk group, mediastinal primary tumor, and Eastern Cooperative Oncology Group (ECOG) 2 status were significantly associated with inferior PFS. In the entire cohort, major grade 3-4 adverse events included neutropenia (38.69%), anemia (4.74%), thrombocytopenia (5.11%), and febrile neutropenia (6.2%), with no death due to pulmonary toxicity.
CONCLUSION: The modified-BEP regimen showed an effective and tolerable treatment alternative for adult male GCT patients in China, offering greater convenience compared to the standard BEP regimen.
METHODS: We conducted a retrospective analysis of 274 adult male GCT patients treated with modified-BEP at the Sun Yat-sen University Cancer Center between 2005 and 2022. The regimen involved a tri-weekly 5-day schedule with 30 IU modified bleomycin (administered on days 1, 3, and 5), 20 mg/m2 cisplatin (days 1-5), and 100 mg/m2 etoposide (days 1-5). The survival rates and safety profiles of the patients were analyzed.
RESULTS: Among the patients, 42 patients received BEP in adjuvant setting, while 232 were treated with BEP in curative setting. With a median follow-up of 41.03 months among the curative patient population, the 5-year progression-free survival (PFS) rate was 79.33%, and the 5-year overall survival (OS) rate was 86.26%. Stratified by the International Germ Cell Cancer Collaborative Group (IGCCCG) prognostic groups, the 5-year OS rates of the good, intermediate, and poor risk groups were 99.05%, 92.84%, and 55.96% (P < 0.0001), respectively. Favorable responses, including complete remission and partial response with negative tumor markers, were achieved in 91.07% of good-risk, 84.13% of intermediate-risk, and 52.63% of poor-risk patients, with a significant difference (P < 0.0001). Multivariate analysis indicated that non-seminoma, poor risk group, mediastinal primary tumor, and Eastern Cooperative Oncology Group (ECOG) 2 status were significantly associated with inferior PFS. In the entire cohort, major grade 3-4 adverse events included neutropenia (38.69%), anemia (4.74%), thrombocytopenia (5.11%), and febrile neutropenia (6.2%), with no death due to pulmonary toxicity.
CONCLUSION: The modified-BEP regimen showed an effective and tolerable treatment alternative for adult male GCT patients in China, offering greater convenience compared to the standard BEP regimen.