Single-course bleomycin, etoposide, and cisplatin (1xBEP) as
adjuvant treatment in testicular nonseminoma clinical stage 1:
outcome, safety, and risk factors for relapse in a
population-based study

J 2022

Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study

DIECKMANN, Klaus-Peter, Tomáš POKRIVČÁK, Lajos GECZI, David NIEHAUS, Inken DRALLE-FILIZ et. al.

Basic information

Original name

Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study

Authors

DIECKMANN, Klaus-Peter (guarantor), Tomáš POKRIVČÁK (203 Czech Republic, belonging to the institution), Lajos GECZI, David NIEHAUS, Inken DRALLE-FILIZ, Cord MATTHIES, Tamas DIENES, Stefanie ZSCHAEBITZ, Pia PAFFENHOLZ, Tanja GSCHLIESSER, Renate PICHLER, Michal MEGO, Pia BADER, Friedemann ZENGERLING, Julia HEINZELBECKER, Philipp KRAUSEWITZ, Susanne KREGE, Gaetano AURILIO, Cem AKSOY, Marcus HENTRICH, Christoph SEIDEL, Peter TOERZSOEK, Tim NESTLER, Matthaeus MAJEWSKI, Andreas HIESTER, Tomas BUCHLER, Sonia VALLET, Hana STUDENTOVA, Sandra SCHOENBURG, Dora NIEDERSUESS-BEKE, Julia RING, Emanuela TRENTI, Axel HEIDENREICH, Christian WUELFING, Hendrik ISBARN, Uwe PICHLMEIER and Martin PICHLER

Edition

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY, LONDON, SAGE PUBLICATIONS LTD, 2022, 1758-8340

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.900

RIV identification code

RIV/00216224:14110/22:00127961

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1177/17588359221086813

UT WoS

000778006500001

Keywords in English

bleomycin; cisplatin; embryonal carcinoma; etoposide; germ-cell tumor; local pathological stage; lymphovascular invasion; nonseminoma

Abstract

V originále

Introduction: Clinical stage 1 (CS1) nonseminomatous (NS) germ cell tumors involve a 30% probability of relapse upon surveillance. Adjuvant chemotherapy with one course of bleomycin, etoposide, and cisplatin (1xBEP) can reduce this risk to <5%. However, 1xBEP results are based solely on five controlled trials from high-volume centers. We analyzed the outcome in a real-life population. Patients and Methods: In a multicentric international study, 423 NS CS1 patients receiving 1xBEP were retrospectively evaluated. Median follow-up was 37 (range, 6-89) months. Primary end points were relapse-free and overall survival evaluated after 5 years. We also looked at associations of relapse with clinico-pathological factors using stratified Kaplan-Meier methods and Cox regression models. Treatment modality and outcome of recurrences were analyzed descriptively. Results: The 5-year relapse-free survival rate was 96.2%. Thirteen patients (3.1%; 95% confidence interval, 1.65-5.04%) relapsed after a median time of 13 months, of which 10 were salvaged (77%). Relapses were mostly confined to retroperitoneal nodes. Three patients succumbed, two to disease progression and one to toxicity of chemotherapy. Pathological stage >pT2 was significantly associated with relapse rate. Conclusion: The relapse rate of 3.1% found in this population of NS CS1 patients treated with 1xBEP at the routine care level was not inferior to the median rate of 2.3% reported from a meta-analysis of controlled trials. Also, the cure rate of relapses of 77% is consistent with the previously reported rate of 80%. This study clearly shows that the 1xBEP regimen represents a safe treatment for NS CS1 patients.

Citovat

DIECKMANN, Klaus-Peter, Tomáš POKRIVČÁK, Lajos GECZI, David NIEHAUS, Inken DRALLE-FILIZ, Cord MATTHIES, Tamas DIENES, Stefanie ZSCHAEBITZ, Pia PAFFENHOLZ, Tanja GSCHLIESSER, Renate PICHLER, Michal MEGO, Pia BADER, Friedemann ZENGERLING, Julia HEINZELBECKER, Philipp KRAUSEWITZ, Susanne KREGE, Gaetano AURILIO, Cem AKSOY, Marcus HENTRICH, Christoph SEIDEL, Peter TOERZSOEK, Tim NESTLER, Matthaeus MAJEWSKI, Andreas HIESTER, Tomas BUCHLER, Sonia VALLET, Hana STUDENTOVA, Sandra SCHOENBURG, Dora NIEDERSUESS-BEKE, Julia RING, Emanuela TRENTI, Axel HEIDENREICH, Christian WUELFING, Hendrik ISBARN, Uwe PICHLMEIER and Martin PICHLER. Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study. THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY. LONDON: SAGE PUBLICATIONS LTD, 2022, vol. 14, March 2022, p. 1-13. ISSN 1758-8340. Available from: https://dx.doi.org/10.1177/17588359221086813.

@article{2246363,
   author = {Dieckmann, KlausandPeter and Pokrivčák, Tomáš and Geczi, Lajos and Niehaus, David and DralleandFiliz, Inken and Matthies, Cord and Dienes, Tamas and Zschaebitz, Stefanie and Paffenholz, Pia and Gschliesser, Tanja and Pichler, Renate and Mego, Michal and Bader, Pia and Zengerling, Friedemann and Heinzelbecker, Julia and Krausewitz, Philipp and Krege, Susanne and Aurilio, Gaetano and Aksoy, Cem and Hentrich, Marcus and Seidel, Christoph and Toerzsoek, Peter and Nestler, Tim and Majewski, Matthaeus and Hiester, Andreas and Buchler, Tomas and Vallet, Sonia and Studentova, Hana and Schoenburg, Sandra and NiedersuessandBeke, Dora and Ring, Julia and Trenti, Emanuela and Heidenreich, Axel and Wuelfing, Christian and Isbarn, Hendrik and Pichlmeier, Uwe and Pichler, Martin},
   article_location = {LONDON},
   article_number = {March 2022},
   doi = {http://dx.doi.org/10.1177/17588359221086813},
   keywords = {bleomycin; cisplatin; embryonal carcinoma; etoposide; germ-cell tumor; local pathological stage; lymphovascular invasion; nonseminoma},
   language = {eng},
   issn = {1758-8340},
   journal = {THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY},
   title = {Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study},
   url = {https://journals.sagepub.com/doi/10.1177/17588359221086813},
   volume = {14},
   year = {2022}
}

TY  - JOUR
ID  - 2246363
AU  - Dieckmann, Klaus-Peter - Pokrivčák, Tomáš - Geczi, Lajos - Niehaus, David - Dralle-Filiz, Inken - Matthies, Cord - Dienes, Tamas - Zschaebitz, Stefanie - Paffenholz, Pia - Gschliesser, Tanja - Pichler, Renate - Mego, Michal - Bader, Pia - Zengerling, Friedemann - Heinzelbecker, Julia - Krausewitz, Philipp - Krege, Susanne - Aurilio, Gaetano - Aksoy, Cem - Hentrich, Marcus - Seidel, Christoph - Toerzsoek, Peter - Nestler, Tim - Majewski, Matthaeus - Hiester, Andreas - Buchler, Tomas - Vallet, Sonia - Studentova, Hana - Schoenburg, Sandra - Niedersuess-Beke, Dora - Ring, Julia - Trenti, Emanuela - Heidenreich, Axel - Wuelfing, Christian - Isbarn, Hendrik - Pichlmeier, Uwe - Pichler, Martin
PY  - 2022
TI  - Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study
JF  - THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY
VL  - 14
IS  - March 2022
SP  - 1-13
EP  - 1-13
PB  - SAGE PUBLICATIONS LTD
SN  - 17588340
KW  - bleomycin
KW  - cisplatin
KW  - embryonal carcinoma
KW  - etoposide
KW  - germ-cell tumor
KW  - local pathological stage
KW  - lymphovascular invasion
KW  - nonseminoma
UR  - https://journals.sagepub.com/doi/10.1177/17588359221086813
N2  - Introduction: Clinical stage 1 (CS1) nonseminomatous (NS) germ cell tumors involve a 30% probability of relapse upon surveillance. Adjuvant chemotherapy with one course of bleomycin, etoposide, and cisplatin (1xBEP) can reduce this risk to <5%. However, 1xBEP results are based solely on five controlled trials from high-volume centers. We analyzed the outcome in a real-life population. Patients and Methods: In a multicentric international study, 423 NS CS1 patients receiving 1xBEP were retrospectively evaluated. Median follow-up was 37 (range, 6-89) months. Primary end points were relapse-free and overall survival evaluated after 5 years. We also looked at associations of relapse with clinico-pathological factors using stratified Kaplan-Meier methods and Cox regression models. Treatment modality and outcome of recurrences were analyzed descriptively. Results: The 5-year relapse-free survival rate was 96.2%. Thirteen patients (3.1%; 95% confidence interval, 1.65-5.04%) relapsed after a median time of 13 months, of which 10 were salvaged (77%). Relapses were mostly confined to retroperitoneal nodes. Three patients succumbed, two to disease progression and one to toxicity of chemotherapy. Pathological stage >pT2 was significantly associated with relapse rate. Conclusion: The relapse rate of 3.1% found in this population of NS CS1 patients treated with 1xBEP at the routine care level was not inferior to the median rate of 2.3% reported from a meta-analysis of controlled trials. Also, the cure rate of relapses of 77% is consistent with the previously reported rate of 80%. This study clearly shows that the 1xBEP regimen represents a safe treatment for NS CS1 patients.
ER  -

DIECKMANN, Klaus-Peter, Tomáš POKRIVČÁK, Lajos GECZI, David NIEHAUS, Inken DRALLE-FILIZ, Cord MATTHIES, Tamas DIENES, Stefanie ZSCHAEBITZ, Pia PAFFENHOLZ, Tanja GSCHLIESSER, Renate PICHLER, Michal MEGO, Pia BADER, Friedemann ZENGERLING, Julia HEINZELBECKER, Philipp KRAUSEWITZ, Susanne KREGE, Gaetano AURILIO, Cem AKSOY, Marcus HENTRICH, Christoph SEIDEL, Peter TOERZSOEK, Tim NESTLER, Matthaeus MAJEWSKI, Andreas HIESTER, Tomas BUCHLER, Sonia VALLET, Hana STUDENTOVA, Sandra SCHOENBURG, Dora NIEDERSUESS-BEKE, Julia RING, Emanuela TRENTI, Axel HEIDENREICH, Christian WUELFING, Hendrik ISBARN, Uwe PICHLMEIER and Martin PICHLER. Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study. \textit{THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY}. LONDON: SAGE PUBLICATIONS LTD, 2022, vol.~14, March 2022, p.~1-13. ISSN~1758-8340. Available from: https://dx.doi.org/10.1177/17588359221086813.

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