{"doi":"10.1200/jco.23.02542","title":"Paclitaxel, Ifosfamide, and Cisplatin as Initial Salvage Chemotherapy for Germ Cell Tumors: Long-Term Follow-Up and Outcomes for Favorable- and Unfavorable-Risk Disease","abstract":"PURPOSE: Paclitaxel, ifosfamide, and cisplatin (TIP) is an established salvage regimen for germ cell tumors (GCT) on the basis of a phase II trial, but efficacy on a large patient cohort including patients with unfavorable risk features and long-term outcomes has not been reported. Herein, we report updated treatment efficacy and long-term follow-up with TIP. PATIENTS AND METHODS: Patients with GCT who received TIP after cisplatin-based chemotherapy were eligible. Favorable response (complete response or partial response with negative tumor markers), overall survival (OS) and progression-free survival (PFS) rates, relapse, and toxicity were determined. Disease was reclassified according to the International Prognostic Factor Study Group (IPFSG) score. RESULTS: Of the 104 patients, 87 had favorable risk factors and 17 had at least one unfavorable factor by Memorial Sloan Kettering Cancer Center (MSKCC) criteria. Ten patients were treated for a second gonadal primary GCT. With a median follow-up of 8.9 years, the 5-year PFS and OS rates were 66% (95% CI, 55 to 74) and 69% (95% CI, 59 to 77), respectively. Among 87 patients with favorable-risk disease, 69 (79%) achieved a favorable response with 5-year PFS and OS rates of 67% (95% CI, 56 to 76) and 72% (95% CI, 61 to 80), respectively. Among 17 patients with MSKCC unfavorable-risk disease, 13 (76%) achieved a favorable response with 5-year PFS and OS rates of 59% (95% CI, 33 to 78) and 56% (95% CI, 28 to 76), respectively. After IPFSG reclassification, 5-year PFS and OS rates for patients with ≤intermediate-risk disease were 75% (95% CI, 50 to 89) and 73% (95% CI, 55 to 85), respectively. CONCLUSION: TIP is an effective second-line regimen for patients with GCT. Similar outcomes were observed in patients with favorable- and unfavorable-risk disease. The randomized TIGER trial (ClinicalTrials.gov identifier: NCT02375204) comparing TIP with high-dose chemotherapy will determine the optimal second-line treatment approach.","journal":"Journal of Clinical Oncology","year":2024,"id":433215,"datarank":0.5561746862625884,"base_score":2.70805020110221,"endowment":2.70805020110221,"self_citation_contribution":0.40620753016533157,"citation_network_contribution":0.1499671560972568,"self_endowment_contribution":0.40620753016533157,"citer_contribution":0.1499671560972568,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":13,"citers_with_citation_signal":7,"citers_with_endowment":7,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.954,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02375204"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":470241,"name":"Andrea Knežević","orcid":"0000-0002-0741-2150","position":1,"is_corresponding":false},{"id":438236,"name":"Maria Bromberg","orcid":"0009-0006-9840-7344","position":2,"is_corresponding":false},{"id":470245,"name":"Sujata Patil","orcid":"0000-0003-1706-5321","position":3,"is_corresponding":false},{"id":439074,"name":"Joel Sheinfeld","orcid":null,"position":4,"is_corresponding":false},{"id":73040,"name":"Brett S. Carver","orcid":"0000-0001-5165-3544","position":5,"is_corresponding":false},{"id":417847,"name":"Manjit S. Bains","orcid":"0009-0001-5406-0784","position":6,"is_corresponding":false},{"id":253867,"name":"David R. Jones","orcid":"0000-0002-3318-0146","position":7,"is_corresponding":false},{"id":108820,"name":"Dean F. Bajorin","orcid":"0000-0003-4001-7088","position":8,"is_corresponding":false},{"id":36574,"name":"George J. Bosl","orcid":"0000-0002-7842-6584","position":9,"is_corresponding":false},{"id":479655,"name":"Deaglan Joseph McHugh","orcid":"0000-0003-1477-0105","position":10,"is_corresponding":false},{"id":325592,"name":"Samuel A. Funt","orcid":"0000-0002-7235-6319","position":11,"is_corresponding":false},{"id":226686,"name":"Robert J. Motzer","orcid":"0000-0001-6925-2327","position":12,"is_corresponding":false},{"id":90735,"name":"Darren R. Feldman","orcid":"0000-0003-2424-4635","position":13,"is_corresponding":false},{"id":989205,"name":"Jack P. Gleeson","orcid":"0000-0001-6908-495X","position":0,"is_corresponding":true}],"reference_count":13,"raw_metadata":null,"created_at":"2026-07-19T01:59:44.444627Z","pmid":"39028926","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}