In the last 3 years, three major trials involving patients with advanced germ cell testicular tumors have investigated dose-intense alternatives to standard BEP (bleomycin, etoposide, and cisplatin) therapy. All three trials failed to reach their accrual targets and none was able to demonstrate improved results.
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References
Williams, S. D. et al. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N. Engl. J. Med. 316, 1435–1440 (1987).
International Germ Cell Cancer Collaborative Group (IGCCCG). International germ cell consensus classification: a prognosis factor-based staging system for metastatic germ cell cancers. J. Clin. Oncol. 15, 594–603 (1997).
Motzer, R. J. et al. Phase III randomized trial of conventional-dose chemotherapy with or without high-dose chemotherapy and autologous hematopoietic stem-cell rescue as first-line treatment for patients with poor-prognosis metastatic germ cell tumors. J. Clin. Oncol. 25, 247–256 (2007).
Daugaard, G. et al. A randomized phase III study comparing standard dose BEP with sequential high-dose cisplatin, etoposide, and ifosfamide (VIP) plus stem-cell support in males with poor-prognosis germ-cell cancer. An intergroup study of EORTC, GTCSG, and Grupo Germinal (EORTC 30974). Ann. Oncol. 22, 1054–1061 (2010).
de Wit, R. et al. Randomized phase III study comparing paclitaxel-bleomycin, etoposide, and cisplatin (BEP) to standard BEP in intermediate-prognosis germ-cell cancer: intergroup study EORTC 30983. J. Clin. Oncol. 30, 792–799 (2012).
Tannock, I. F. False-positive results in clinical trials: multiple significance tests and the problem of unreported comparisons. J. Natl Cancer Inst. 88, 206–207 (1996).
Amir, E., Seruga, B., Kwong, R., Tannock, I. F. & Ocaña, A. Poor correlation between progression-free and overall survival in modern clinical trials: are composite endpoints the answer? Eur. J. Cancer 48, 385–388 (2012).
Fosså, S. D. et al. Intensive induction chemotherapy with C-BOP/BEP for intermediate- and poor-risk metastatic germ cell tumors (EORTC trial 30948). Br. J. Cancer 93, 1209–1214 (2005).
Rimmer, Y. et al. Accelerated BEP: a phase I trial of dose-dense BEP for intermediate and poor prognosis metastatic germ cell tumor. Br. J. Cancer 105, 766–772 (2011).
Collette, L. et al. Impact of the treating institution on survival of patients with “poor-prognosis” metastatic nonseminoma. European Organization for Research and Treatment of Cancer Genito-Urinary Tract Cancer Collaborative Group and the Medical Research Council Testicular Cancer Working Party. J. Natl Cancer Inst. 91, 839–846 (1999).
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Williams, M., Mazhar, D. Poor trial accrual hinders germ cell tumor therapy advances. Nat Rev Urol 9, 243–245 (2012). https://doi.org/10.1038/nrurol.2012.59
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DOI: https://doi.org/10.1038/nrurol.2012.59
