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Seminoma 3-4 y relapse. AUC vs BEP

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  • Seminoma 3-4 y relapse. AUC vs BEP

    Hi guys,

    Many thanks for all your continuous help and support. This forum has been a source of so many useful information and encouragement!

    My seminoma just came back. I've had orchiectomy on my leftie in Oct 2016, went for simple surveillance.

    Now, it seems I have a 5 cm bulky mass retro. I thought for sure, they will offer 3xBEP. However, seems they ( St Barts London) have this new regimen of 3 x Carboplatin AUC 10,
    which gave good results in a 200 patients cohort.

    They quoted a 2/3 years relapse free survival odds of 94-95% and less short term toxicity.

    What do you guys think ? I already emailed dr Einhorn but he will probably encourage me to go for BEP.

    From the paper they published, from 216 patients with good prognostic seminoma, they had 10 relapses, from which 5 were successfully treated with BEP which makes me think BEP is
    slightly better.

    Many thanks,

    Radiotherapy and cisplatin-based combination chemotherapy are accepted standard-of-care treatments for metastatic seminoma with excellent survival out…

  • #2
    HI, I also had the Carboplatin AUC 10 three years ago for Stage 2 Seminoma (small retroperitoneal (c2cm) nodes at diagnosis) at Barts. I found the chemo not too bad tbh, no real side effects and I was able to keep up my 10K steps a day walking all the way through. One aspect is that with this treatment you don't have hair loss.

    From the paper : "There were seven relapses, of which 5 were successfully salvaged with further chemotherapy ± surgery, and three non-seminoma–related deaths. There were no treatment-related deaths." Not sure how that matches up with BEP statistics for similar cases and we don't know the full details of the cases that needed more treatment.

    I looked at this very useful post on here when I had to make a similar decision : as this guy had the same treatment.

    Let me know if you have any other questions.


    • #3
      Thanks @dave, the post is really useful indeed !

      Yes, I think I m going to give it a try and see how it goes. I m pushing for 4 cycles to be more in line with what the paper described for stage 2c/3.

      Dr Einhorn was not very enthusiastic about it to say the least. Worst come worst, and not ideal, I'd still have BEP as second line chemo.

      Did you have complete response ? Seems like they got 50% of patients not having a complete response , but my understanding is they wouldn't do RPLND unless >3cm.


      • #4
        Yes I had complete response fortunately.


        • #5
          Well, supe, every successful medical treatment had to start somewhere, and the early results, although a rather small group, are promising, & the major risk seems to be more chemo. A bigger concern is there are no long term (10+ year) results yet, but if you are comfortable being on the cutting edge, by all means go for it.

          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP


          • #6
            Thanks Dave, I m more inclined now to go for BEP, but I l'll have another chat with my Oncologist.

            In terms of long terms effects of BEP, are they manageable, or they really decrease the quality of life?


            • #7
              I completed BEPx3 back in January and have no lasting effects. The process isn't fun, but I wouldn't expect any long-term side effects.


              • #8
                Some get tinnitus, others, peripheral neuropathy ( I got some of both, I'm 10 years out). There are a few others, but none seem to be impossible to deal with & most seem to have rather normal lives afterwards.

                Jan, 1975: Right I/O, followed by RPLND
                Dec, 2009: Left I/O, followed by 3xBEP


                • #9
                  hi supeescientifi, may I ask Dr. Einhorn's email address? my husband was diagnosed non-seminoma, I also want to consult him about the chemo regimen after orchiectomy. we are struggling to go with 3 or 4 cycles of BEP...


                  • #10
                    Nan, has his CT scan shown that it has spread?
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP