Prior D, Yang J, Nuño MM, Shaikh F, Frazier AL, Pashankar F. Standard-Dose Versus High-Dose Cisplatin for Intermediate/Poor-Risk Extracranial Malignant Germ Cell Tumors: Re-Analysis of Pediatric Oncology Group 9049 and Children’s Cancer Group 8882 Trial Using Updated MaGIC Risk Stratification. Pediatr Blood Cancer. 2025 Jun;72(6):e31665. doi: 10.1002/pbc.31665. Epub 2025 Mar 17. PMID: 40098231; PMCID: PMC12018124.
Study ID Citation
Abstract
Cisplatin, etoposide, and bleomycin (PEb) have been the standard of care for patients with germ cell tumors (GCT). In the 1990s, an intergroup trial (POG9049/CCG8882) randomized patients with high-risk GCT, as defined by the 1990 criteria, to high-dose (HDPEb) versus standard-dose PEb. HDPEb resulted in improved event-free survival (EFS), but no difference in overall survival (OS), thus standard-dose PEb has remained the standard of care. Subsequently, the Malignant Germ Cell International Consortium (MaGIC) updated the risk stratification for pediatric and adolescent patients with GCT. Currently, patients are categorized as intermediate or poor risk if they are ≥11 years of age with Stage IV ovarian GCT, or testicular, mediastinal, or retroperitoneal GCT with intermediate or poor prognosis using the International Germ Cell Consensus Classification criteria.