From the Journals

EPx4 Raises Odds of Renal, Nerve, Hearing Harms

Multicenter outcomes study finds cisplatin dose drives toxicity differences between guideline-endorsed regimens, with kidney function decline predicting cardiovascular risk

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A comprehensive analysis of long-term survivors of testicular cancer reveals that those treated with four cycles of etoposide and cisplatin (EPx4) face significantly higher risks of renal impairment, ototoxicity, and peripheral neuropathy compared to patients who received three cycles of bleomycin, etoposide, and cisplatin (BEPx3). Conducted across eight cancer centers from 2012 to 2018, the study highlights the importance of treatment regimens and cumulative cisplatin doses, and their direct impact on patient health outcomes, including hypertension and cardiovascular disease.

Original Source(s)

EPx4 Raises Odds of Renal, Nerve, Hearing Harms

Multicenter outcomes study finds cisplatin dose drives toxicity differences between guideline-endorsed regimens, with kidney function decline predicting cardiovascular risk

  • by Kerri Miller

  • February 25, 2026

  • 5 min

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