{"entity":{"id":"paper-getug-13-fizazi-lancet-oncol-2014","kind":"paper","name":"GETUG 13: personalised chemotherapy based on tumour marker decline in poor-prognosis germ cell tumours","aka":[],"tldr":"In poor-risk testicular cancer, men whose tumour markers fell slowly after the first cycle of BEP did better when switched to an intensified dose-dense regimen, the first trial to individualise chemotherapy by early marker response.","summary":"Phase 3 trial of 263 men with poor-prognosis non-seminomatous germ cell tumours; those with unfavourable tumour marker decline after one cycle of BEP were randomised to continue BEP or switch to a dose-dense regimen (paclitaxel-BEP-oxaliplatin alternating with cisplatin-ifosfamide-bleomycin).\n\nThree-year progression-free survival was 59 percent with dose-dense therapy against 48 percent with BEP (hazard ratio 0.66), with more haematological toxicity but no increase in toxic deaths; overall survival was not significantly different.","asOf":"2026-09-17","links":[{"label":"Lancet Oncol 2014","url":"https://doi.org/10.1016/S1470-2045(14)70490-5"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/25456363/"}],"tags":[],"related":[],"cancers":["non-seminoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet-oncology"],"dependsOn":[],"notes":[],"journal":"The Lancet Oncology","year":2014,"doi":"10.1016/S1470-2045(14)70490-5","pmid":"25456363","authors":"Fizazi K, Pagliaro L, Laplanche A, et al.","paperType":"rct","findings":["Three-year progression-free survival 59 percent vs 48 percent; hazard ratio 0.66.","Favourable marker decline identified men doing well on standard BEP (70 percent progression-free survival)."],"whatItMeans":"Marker decline after the first BEP cycle is now assessed in poor-risk disease, and intensification is offered in expert centres to slow decliners.","caveats":["No significant overall survival difference; toxicity of the intensified regimen requires specialist care."],"changedPractice":true,"participants":263},"route":"/key-papers/paper-getug-13-fizazi-lancet-oncol-2014/","neighbours":{"cancer":[{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}