Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

BEP in germ cell (testicular) tumours

Bleomycin, etoposide and cisplatin; 3 or 4 cycles by risk group

Updated: 28 October 20261 min read2 references

Summary for doctors

  • Good risk (IGCCCG): 3 cycles; intermediate or poor risk: 4 cycles [1].
  • This is a curable cancer: do not change dose or timing except in dangerous situations.
  • Pulmonary function tests (DLCO) before bleomycin.

Dose and schedule

BEP

Metastatic germ cell tumour (seminoma or non-seminoma)Cycle length: Every 21 days

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Cisplatin hydration and magnesium and potassium replacement; highly emetogenic antiemetics (NK1, 5-HT3, dexamethasone, olanzapine).
  • G-CSF if needed to keep to schedule; do not delay a cycle for afebrile neutropenia (per protocol).
  • Fertility preservation (sperm banking) before starting.

Monitoring and dose adjustment

  • Bleomycin: maximum cumulative dose 400 units; stop with cough, dyspnoea or a fall in DLCO; limit high-concentration oxygen (for example during later anaesthesia); toxicity is greater with renal impairment.
  • Creatinine and hearing; neuropathy.
  • Markers (AFP, beta-hCG, LDH) before each cycle.

Main evidence

Show detailsHide

BEP was as effective as or better than PVB with less neuropathy and neuromuscular toxicity, and became the standard [1]. More than 90% of good-risk patients are cured.

Related cancer types

Testicular cancer

References

2 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposideWilliams SD, Birch R, Einhorn LH, et al · N Engl J Med · 1987;316:1435-40
    Study cardDOIPubMed Back to text: 1 2 3
  2. 2
    Personalised chemotherapy based on tumour marker decline in poor prognosis germ-cell tumours (GETUG 13): a phase 3, multicentre, randomised trialFizazi K, Pagliaro L, Laplanche A, et al · Lancet Oncol · 2014;15:1442-1450
    DOIPubMed Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/bep/

Related pages

27 October 2026 FOLFOX (mFOLFOX6): dose, schedule and side effects Dose and schedule of mFOLFOX6 (oxaliplatin 85, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), length of adjuvant treatment, premedication, neuropathy and dose adjustment. 27 October 2026 CAPOX (XELOX): dose, schedule and side effects Dose and schedule of CAPOX or XELOX (oxaliplatin 130 and capecitabine 1000 twice daily, days 1 to 14), length of adjuvant treatment, renal adjustment and side effects. 27 October 2026 FOLFIRI regimen: dose, schedule and side effects Dose and schedule of FOLFIRI (irinotecan 180, leucovorin 400, fluorouracil 400 bolus and 2400 as a 46-hour infusion), diarrhoea control, UGT1A1 and dose adjustment.