Conventional-Dose versus High-Dose Chemotherapy for Relapsed Germ Cell Tumors

Table 2

Studies examining the use of high-dose chemotherapy as initial (or later) salvage therapy.

Author (Year)	Study design	N	Notable I/E criteria	Median f/u (m)	HDCT as initial salvage	HDCT regimen	Cycles	Durable CR	OS
Einhorn et al. [7]	Retrospective	184	I: None; E: PM-NSGCT and late relapse	48	73%	Carboplatin 700 mg/m^2 (d 1–3); Etoposide 750 mg/m^2 (d 1–3)	2	58% 2-year DFS	65% at 5 years
Feldman et al. [8]	Prospective, phase I/II	107	I: ≥1 adverse prognostic feature for salvage CDCT^a; E: None	61	76%	Part A (TI): Paclitaxel 200 mg/m^2 (d 1); Ifosfamide 2000 mg/m^2 (d 1–3)	2	48% 5-year DFS	52% at 5 years
						Part B (CE): Carboplatin AUC 7-8 (d 1–3) Etoposide 400 mg/m^2 (d 1–3)	3
Lorch et al. [20]	Prospective, randomized phase III	211	I: None; E: None	90	86%	Arm A: VIP	1	52% 2-year PFS	50% at 5 years
						Carboplatin 500 mg/m^2 (d 1–3); Etoposide 500 mg/m^2 (d 1–3)	3
						Arm B: VIP	3	47% 2-year PFS	40% at 5 years
						Carboplatin 550 mg/m^2 (d 1–4); Etoposide 600 mg/m^2 (d 1–4); Cyclophosphamide 1600 mg/m^2 (d 1–4)	1
Adra et al. [9]	Retrospective	364	I: None; E: Late relapse	40	83%	Carboplatin 700 mg/m^2 (d 1–3); Etoposide 750 mg/m^2 (d 1–3)	2	60% 2-year PFS	66% at 2 years

I, inclusion; E, exclusion; HDCT, high-dose chemotherapy; f/u, follow-up; m, months; CR, complete response; OS, overall survival; PM-NSGCT, primary mediastinal nonseminomatous germ cell tumor; d, day; DFS, disease-free survival; AUC, area under the curve; PFS, progression-free survival; VIP, etoposide, ifosfamide, and cisplatin; ^aextragonadal primary site, incomplete response (IR) to first-line therapy, and PD after a salvage CDCT (cisplatin plus ifosfamide-based) regimen.