cyclophosphamide + cisplatin + etoposide + bleomycin

Cyclophosphamide + cisplatin + etoposide + bleomycin (C-PEB) is a combination chemotherapy regimen investigated by the Children's Oncology Group (COG) for the treatment of high-risk extracranial malignant germ cell tumors in children and adolescents. This regimen adds cyclophosphamide, a nitrogen mustard alkylating agent, to the standard PEB backbone consisting of cisplatin, etoposide, and bleomycin. The combination works through multiple cytotoxic mechanisms: cyclophosphamide and cisplatin induce DNA cross-linking and alkylation; etoposide inhibits DNA topoisomerase II, leading to double-strand breaks; and bleomycin causes oxidative damage resulting in DNA cleavage. The regimen was evaluated in the AGCT01P1 pilot phase I study to determine the maximum tolerated dose of cyclophosphamide when added to PEB. Although the combination was found to be feasible and well-tolerated at all dose levels tested, the study did not demonstrate a significant improvement in event-free survival compared to standard PEB therapy alone.

Other names

Cyclophosphamide with PEBC-PEB regimenCPM-PEB