Treatment of ovarian germ cell tumors with a 3-day bleomycin, etoposide, and cisplatin regimen: a prospective multicenter study

Gynecol Oncol. 2004 Dec;95(3):695-700. doi: 10.1016/j.ygyno.2004.08.018.


Background: Ovarian germ cell tumors (OGCT) are highly curable when treated with cytoreductive surgery and platinum-based chemotherapy. We evaluated the safety and activity of a 3-day modified bleomycin, etoposide, and cisplatinum (mBEP) regimen in patients with OGCT.

Patients and methods: Patients with FIGO stages I-IV OGCT were treated with three (stages I-III complete resection) or four cycles (incomplete resection or stage IV) of bleomycin 15 mg iv, etoposide 120 mg/m(2) iv, and cisplatin 40 mg/m(2) iv for 3 days every 3 weeks.

Results: Forty-eight patients (14 with dysgerminoma and 34 with non-dysgerminomatous tumors) were included in our study. Most patients had stage I disease (65%) and complete resection of their tumor (67%). Twenty percent of patients developed grade 3 or 4 neutropenia with 4 episodes of neutropenic fever. During follow-up (median: 5 years), two patients developed progressive disease including one patient who died. All patients with stage I or II disease and all patients with dysgerminoma remain free of disease. However, 20% of patients with non-dysgerminomatous tumors stage III or IV experienced progressive disease.

Conclusion: The modified 3-day BEP regimen was safe and effective in patients with OGCT. Further improvements are needed for patients with advanced, suboptimally debulked non-dysgerminomatous tumors.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bleomycin / administration & dosage
  • Bleomycin / adverse effects
  • Child
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Disease Progression
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Germinoma / drug therapy*
  • Germinoma / pathology
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / secondary
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / pathology
  • Prospective Studies


  • Bleomycin
  • Granulocyte Colony-Stimulating Factor
  • Etoposide
  • Cisplatin

Supplementary concepts

  • BEP protocol