Find out what PEI is, how you have it and other important information about having this drug combination.
What is it
PEI is the name of a combination of chemotherapy drugs used to treat testicular cancer that has spread or come back. It is also called VIP or IPE.
It is made up of the following drugs:
How it works
These chemotherapy drugs destroy quickly dividing cells, such as cancer cells.
How you have it
You have these drugs as a drip into your bloodstream.
Into your bloodstream
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
When you have it
You usually have PEI chemotherapy as cycles of treatment. Each cycle of treatment lasts 3 weeks (21 days). You have 4 cycles, taking 3 months in total.
- You have etoposide as a drip into your bloodstream
- You have cisplatin as a drip into your bloodstream
- You have ifosfamide as a drip into your bloodstream
During this time, you usually stay in hospital as an inpatient.
- You have no treatment
You then start the next treatment cycle.
Mesna and GCSF injections
You usually have ifosfamide together with another drug called mesna. You have mesna as a drip (infusion) into your vein.
Mesna is not a chemotherapy drug. It stops the ifosfamide from irritating your bladder lining and making it bleed.
You might also have injections of a drug called GCSF with each treatment. This is a type of growth factor that makes the body produce white blood cells to try to reduce the risk of infections.
Tests during treatment
You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
This treatment might stop you being able to father a child.
Talk to your doctor before starting treatment if you think you may want to have a baby in the future.
You may be able to store sperm before starting treatment.
Usually, fertility returns to normal after a few months or sometimes years. You can have sperm counts to check your fertility when your treatment is over. Ask your doctor about it.
Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and Zostavax (shingles vaccine).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine
- be in contact with other people who've had live vaccines as injections
Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, you mustn't change their nappies for 2 weeks after their vaccination.
You also need to avoid anyone who has had oral polio or typhoid vaccination recently.
Treatment for other conditions
Always tell other doctors, nurses or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Pregnancy and contraception
This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.