paclitaxel + bleomycin + etoposide + cisplatin + oxaliplatin + ifosfamide

This dose-dense, intensified chemotherapy regimen is designed for young adults with poor-prognosis non-seminomatous germ cell tumors (NSGCT). Developed and evaluated by Gustave Roussy, the regimen is typically triggered by an unfavorable decline in tumor markers (hCG and AFP) after the first cycle of standard BEP (bleomycin, etoposide, and cisplatin). The intensified protocol involves a sequence of paclitaxel, bleomycin, etoposide, cisplatin, and oxaliplatin (T-BEP-Ox), followed by cycles of cisplatin, ifosfamide, and paclitaxel (TIP). The mechanism of action involves multiple pathways: DNA alkylation and cross-linking (cisplatin, oxaliplatin, ifosfamide), inhibition of topoisomerase II (etoposide), induction of oxidative stress and DNA strand breaks (bleomycin), and stabilization of microtubules to inhibit mitosis (paclitaxel). This multi-pronged approach aims to overcome chemoresistance in high-risk patients through dose intensification and sequential administration of non-cross-resistant agents.

Other names

T-BEP-Oxaliplatin followed by TIPDose-dense regimenGustave Roussy dose-dense regimenT-BEP-Oxaliplatin followed by Cisplatin - Ifosfamide - Paclitaxel