Onco Wiki / Indicação

Testicular germ cell tumor (GCT) · BEP (bleomycin + etoposide + cisplatin, germ cell tumor)

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Pistapadrão
Regime associadoREG-BEP-GCT
IDIND-GCT-METASTATIC-1L-BEP
TipoIndicação
Estadopending_clinical_signoff
DoençasDIS-TESTICULAR-GCT
FontesSRC-IGCCC-1997 SRC-NCCN-TESTICULAR-2025

Notas

Testicular GCT is unique — curative even at metastatic stage for most patients. Post-BEP residual mass management: seminoma >3cm → PET-guided (FDG-avid → biopsy/resection; FDG-negative → observe); NSGCT >1cm → RPLND for residual teratoma resection. Surveillance after good-risk GCT: CT CAP q3-4 months year 1, then q6 months year 2-3; markers q1-2 months year 1. 2L salvage: TIP (paclitaxel + ifosfamide + cisplatin) or VIP (vinblastine + ifosfamide + cisplatin) for cisplatin-sensitive relapse; high-dose chemotherapy + ASCT at specialized centers for multiply relapsed/refractory GCT.

Evidence for specific statements

These citations cover only the statements and scopes shown. They do not establish clinical approval of this record.

Bleomycin exposure warrants perioperative pulmonary-risk assessment. Label precautions favor lower oxygen concentrations, but observational evidence does not establish a universal FiO2 ceiling. Anesthesia should balance pulmonary risk with adequate oxygenation; a fixed limit must not cause inadequate oxygenation.

Perioperative oxygen management after bleomycin only; no verification of other BEP dosing or supportive-care statements.

SRC-BLEOMYCIN-US-LABEL SRC-AAKRE-BLEOMYCIN-PERIOPERATIVE-2014 SRC-BLEOMYCIN-OXYGEN-MONITORING-1984

Bleomycin label pulmonary adverse reactions; Aakre 2014 Results/Discussion; PMID 6200191 abstract.

Primary G-CSF prophylaxis is not universally required for metastatic testicular BEP; clinicians may choose it to maintain dose intensity. Supportive therapy follows individual assessment and institutional protocol.

G-CSF supportive-care selection only; no approval of anticancer dosing, renal adjustments or treatment eligibility.

SRC-EVIQ-TESTICULAR-BEP-320

eviQ 320 v9 treatment schedule footnote ** and supportive therapy defaults paragraph.

New cough or dyspnea during bleomycin treatment requires assessment for pulmonary toxicity; HRCT is preferred when toxicity is suspected. PFT/DLCO is adjunctive, is not a sole automatic stop rule and does not guarantee prevention of pulmonary toxicity.

Pulmonary symptom assessment and role of PFT/DLCO only; no blanket validation of other BEP claims.

SRC-BLEOMYCIN-UK-BEST-PRACTICE-2018

British Journal of Cancer best-practice guideline: role of PFTs and symptom monitoring sections.

Bleomycin unit systems must be identified explicitly. The eviQ equivalence is 1.5 USP units = 1500 International Units, so 30 USP units = 30000 International Units. US product vials are labelled 15 or 30 units of Bleomycin for Injection USP. Do not interpret milligram activity as a general mg-by-weight conversion.

Unit nomenclature and equivalence only; not individualized dosing, schedule selection, cumulative-risk elimination or whole-record clinical approval.

SRC-BLEOMYCIN-US-LABEL SRC-EVIQ-TESTICULAR-BEP-320

US label Description/How supplied; eviQ 320 treatment schedule bleomycin equivalence footnote.

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