Treatment Name: BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day
BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day is a Chemotherapy Regimen for Testicular Cancer
How does BEP work?
Each of the medications in BEP is designed to slow the growth of and kill cancer cells.
B - Bleomycin
E - Etoposide
P - Platinol® (Cisplatin)
Alternative names: bep, bep chemo
Goals of therapy:
BEP is given to shrink tumors and alleviate the signs and symptoms of testicular cancer. BEP is commonly given with the goal of cure.
- Bleomycin intravenous (I.V.) infusion over 10 minutes on Days 1, 8, and 15
- Etoposide I.V. infusion over 1 hour on Days 1, 2, and 3
- Cisplatin I.V. infusion over 1 hour on Days 1 and 2 only
Typically, all three drugs are given on day 1. CIsplatin and Etoposide are then given on day 2, but only etoposide is given on day 3 of each cycle. Bleomycin is typically given on days 1, 8, and 15, but may be changed to days 2, 9, and 16 instead.
Estimated total infusion time for this treatment:
- Up to 3 hours
- Infusion times are based on clinical studies, but may vary depending on doctor preference or patient tolerability. Pre-medications and intravenous (I.V.) fluids, such as hydration, may add more time
BEP is usually given in an outpatient infusion center, allowing the person to go home afterwards. On occasion, BEP may be given in the hospital.
BEP is repeated every 21 days. This is known as one cycle. Each cycle may be repeated up to 4 times, depending upon the stage of the disease and specific type of testicular cancer. Duration of therapy may last up to 4 months, depending upon response, tolerability, and number of cycles prescribed.
Click here for common starting doses
In a multi-drug regimen, each medication has unique side effects. When these medicines are given together, drug-related side effects reported in clinical studies give the best estimate of what to expect. In clinical studies, the most commonly reported side effects with BEP are shown here:
It is important to note that these studies were done when many of the anti-nausea medications we have now were not available. Today, the percent of patients experiencing Nausea or Vomiting is expected to be much lower.
How often is monitoring needed?
Labs (blood tests) may be checked before and during therapy as well as periodically in follow-up after each cycle. Labs often include: Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), blood magnesium levels, blood potassium levels, plus any others your doctor may order.
How often is imaging needed?
Imaging may be checked before treatment, immediately after treatment is finished, and during routine follow-up. Imaging may include: computed tomography (CT) scan, magnetic resonance imaging (MRI), bone scan, or x-ray.
Pulmonary functions tests (PFTs) are typically performed prior to starting treatment to ensure your lungs are healthy enough to receive bleomycin. These may be rechecked during treatment and after treatment is finished during routine follow-up.
How might blood test results/imaging affect treatment?
Depending upon the results, your doctor may advise to continue BEP as planned, or delay or switch therapy
- Intravenous (I.V.) fluids may be given while receiving cisplatin to maintain good hydration and protect against kidney damage. These fluids may contain electrolytes such as potassium and magnesium
- Prior to the first dose of bleomycin on cycle 1 only, a small test dose of bleomycin is sometimes given to ensure that no infusion reactions occur. If the test dose is tolerated, the remainder of the full dose is infused. The test dose does not need to be repeated every cycle
- Treatment with BEP may decrease sperm count. Prior to starting treatment, discuss with your doctor options for sperm banking, if interested
- Typically, filgrastim (Neupogen®) is given after chemotherapy to stimulate production of white blood cells and avoid periods of neutropenia
- A pharmacist should ALWAYS review your medication list to ensure that drug interactions are prevented or managed appropriately
- Clinical trials may exist for testicular cancer. Ask your doctor if any studies are currently enrolling in your area. If not, go to clinicaltrials.gov to search for other centers offering study medications.
Patient Assistance & Co-payment Coverage
Patients under the age of 65 years, or those with private insurance plans:
If you have insurance and are looking for patient assistance or copay assistance for BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day, we have provided links that may help.
Visit our Patient Assistance page and click the links to various patient assistance programs for help paying for BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day. Depending upon your income, they may be able to help cover the cost of:
For Branded medications (may be available for generic medications too), check with the manufacturer to determine if a co-pay card is offered and if it could reduce your monthly copay.
- If you are uninsured, check with the manufacturer to determine if you are eligible to receive medication at no cost.
Medicare and Medicaid patients (Patients 65 years or older):
The clinic providing treatment will likely pre-authorize medications and immune therapies such as BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day and are the best source to help you understand drug cost.
- Ask to speak with a patient assistance technician or financial counselor at the clinic or hospital administering this therapy.
What is Emotional Wellness?
Emotional wellness is having a positive outlook balanced with a realistic understanding of current life events. This requires both an awareness and acceptance of your emotions. It is with this knowledge that you can develop a plan to take the necessary actions to positively impact your life.
Emotional wellness uses an ongoing process to continually reflect on the stressors of life in a constructive manner to move forward and create happiness.
Because emotional wellness is deeply connected with physical, social, and spiritual wellness, pursuing it often becomes particularly difficult in times of major illness. Despite this difficulty, working toward emotional wellness has been connected to improved treatment outcomes and a higher likelihood of achieving goals of therapy.
Learn more about pursuing emotional wellness while receiving treatment with BEP (Bleomycin + Etoposide + Cisplatin)­ 3-Day