Single-center phase 2 trial of paclitaxel-ifosfamide-cisplatin as initial salvage chemotherapy for germ cell tumors: long-term follow-up

Paclitael, ifosfamide, and cisplatin (TIP) is an established salvage regimen for germ cell tumors (GCT), but efficacy on a large patient cohort including patients with unfavorable risk features has not been reported. A phase 2 trial at Memorial Sloan Kettering Cancer Center (New York, NY) investigated long-term efficacy of TIP in a cohort of 104 patients (17 unfavorable-risk diease) after first-line cisplatin. With a median follow-up of 8.9 years, the 5-year progression-free and overall survival rates were 66% (95% CI 55-74) and 69% (59-55), respectively. Among patients with favorable-risk disease, 79% achieved a favorable response; among patients with unfavorable-risk disease, 76% achieved a favorable response. The authors conclude that TIP is an effective second-line regimen for GCT patients. The randomized TIGER trial comparing TIP with high-dose chemotherapy will determine the optimal second-line treatment approach.