title: Low-dose induction chemotherapy with Baby-BOP in patients with metastatic germ-cell tumours does not compromise outcome: a single-centre experience.
abstract: BACKGROUND
  In some institutions advanced metastatic germ-cell tumour (GCT) is treated with low-dose induction chemotherapy in specific settings. There is a lack of published data supporting its use. The data presented here specifically address this issue for the first time.
  
  
  METHODS
  Twenty patients with metastatic GCT treated were with low-dose induction chemotherapy [Baby-BOP (bBOP)] between 1998 and 2009. We report the toxicity and outcome and compare it with a control group.
  
  
  RESULTS
  bBOP was well tolerated with no treatment-related deaths and a lack of chemotherapy-related toxicity. It was associated with a significant fall in tumour markers (median HCG fell from 35 195 to 11 028 IU/l). The first subsequent cycle of standard chemotherapy was administered a median of 9.5 days after initial treatment and was not associated with excess toxicity. The 2-year overall survival of the poor-prognosis patients treated with bBOP was 79.0% [95% confidence interval (CI) 48% to 93%], which is not significantly different from the 2-year overall survival of 80% [95% CI 55% to 92%] of the poor-prognosis patients, who did not receive bBOP.
  
  
  CONCLUSIONS
  Low-dose induction chemotherapy can be given safely in selected individuals and does not adversely affect subsequent chemotherapy or outcome.
authors.affiliation: Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK; Department of Oncology-Haematology, Kantonsspital St Gallen, Switzerland.
authors.forename: S
authors.initials: S
authors.lastname: Gillessen
authors.affiliation: Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK.
authors.forename: T
authors.initials: T
authors.lastname: Powles
authors.affiliation: Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Lim
authors.affiliation: Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Wilson
authors.affiliation: Department of Medical Oncology, Experimental Cancer Medicine Centre, St Bartholomew's Hospital, West Smithfield, London, UK. Electronic address: jonathan.shamash@bartsandthelondon.nhs.uk.
authors.forename: J
authors.initials: J
authors.lastname: Shamash
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D001761:Bleomycin; D014750:Vincristine; D002945:Cisplatin