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Long‑term outcomes of paclitaxel, ifosfamide, and cisplatin (TIP) as second‑line salvage therapy were evaluated in 104 patients with relapsed germ cell tumors. After a median follow‑up of 8.9 years, 5‑year progression‑free and overall survival rates were 66% and 69%, respectively. Favorable response (complete response or partial response with negative tumor markers) occurred in 79% of favorable‑risk and 76% of unfavorable‑risk patients. Five‑year overall survival was 72% in favorable‑risk and 56% in unfavorable‑risk patients. TIP is an effective second‑line regimen with comparable outcomes across risk strata, supporting its continued use while awaiting results from the randomized TIGER trial comparing TIP with high‑dose chemotherapy.
Fig. 1 OS by IPFSG group in all patients (panel A) and favorable cohort (panel B). (Gleeson JP, et al., 2024)
References
A phase III randomized trial compared paclitaxel/carboplatin (PC) versus paclitaxel/ifosfamide (PI) in 536 patients with uterine carcinosarcoma (UCS) and 101 with ovarian carcinosarcoma (OCS). In UCS patients, PC was noninferior to PI, with median overall survival of 37 versus 29 months (HR 0.87; 90% CI, 0.70‑1.075; P<0.01 for noninferiority). Progression‑free survival was significantly better with PC (16 vs. 12 months; HR 0.73; P<0.01). Toxicity profiles differed: more hematologic toxicity with PC, more confusion and hemorrhage with PI. The authors conclude that PC should be the standard regimen for UCS.
Fig. 2 Forest plot of treatment effect on OS by subgroup of (A) all eligible patients with UCS and (B) all eligible patients with OCS. (Powell MA, et al., 2022)
References
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