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Five-year survival rates for testicular germ-cell cancer patients who initially receive good, intermediate, and poor prognoses are 91%, 79%, and 48%, respectively, according to International Germ Cell Consensus Classification (IGCCC) groupings. Despite these favorable outcomes, some patients suffer toxic effects from the current mainstay chemotherapy regimen of bleomycin, etoposide, and cisplatin (BEP).
One hypothesis is that toxicity to healthy tissue is influenced by variations in genes that affect the metabolism or target pathways of these cytotoxic agents. In fact, variation of the bleomycin hydrolase (BLMH) gene — which produces the BLMH enzyme that inactivates bleomycin — is associated with bleomycin-induced pulmonary toxicity in mice.…