{"entity":{"id":"paper-getug-13-marker-guided-dose-dense-chemotherapy-fizazi-lancet-oncol-2014","kind":"paper","name":"GETUG 13: personalised chemotherapy based on tumour marker decline in poor-prognosis germ cell tumours","aka":[],"tldr":"Men with poor-prognosis testicular cancer whose tumour markers fell too slowly after one cycle of BEP did better when their chemotherapy was intensified, with fewer needing high-dose salvage treatment.","summary":"Phase 3 multicentre randomised trial: of 263 patients with poor-prognosis non-seminomatous germ cell tumours, 203 with an unfavourable marker decline after one BEP cycle were randomised to continue BEP (98) or switch to dose-dense chemotherapy (105); 51 with a favourable decline continued BEP.\n\nThree-year progression-free survival was 59 percent with dose-dense chemotherapy against 48 percent with BEP (hazard ratio 0.66, p 0.05) and 70 percent in the favourable group. More grade 3 to 4 neurotoxicity and haematotoxicity occurred with intensification, with no difference in toxic deaths; salvage high-dose chemotherapy was needed in 6 against 16 percent.","asOf":"2026-09-22","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","testicular"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["getug-13"],"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 (95% CI 49 to 68) versus 48 percent (38 to 59); hazard ratio 0.66 (0.44 to 1.00), p 0.05.","Favourable marker decline group: three-year progression-free survival 70 percent (57 to 81).","Salvage high-dose chemotherapy 6 versus 16 percent; grade 3 to 4 neurotoxicity 7 versus 1 percent."],"whatItMeans":"Early tumour marker decline should guide treatment intensification in poor-prognosis germ cell tumours, which is now standard in expert centres.","caveats":["Borderline statistical significance; the dose-dense regimen is complex and toxic and belongs in high-volume centres."],"changedPractice":true,"participants":263},"route":"/key-papers/paper-getug-13-marker-guided-dose-dense-chemotherapy-fizazi-lancet-oncol-2014/","neighbours":{"cancer":[{"id":"non-seminoma","kind":"cancer","name":"Non-seminomatous germ cell tumour","route":"/cancers/non-seminoma/"},{"id":"testicular","kind":"cancer","name":"Testicular germ cell tumours","route":"/cancers/testicular/"}],"trial":[{"id":"getug-13","kind":"trial","name":"GETUG 13","route":"/trials/getug-13/"}],"journal":[{"id":"lancet-oncology","kind":"journal","name":"The Lancet Oncology","route":"/journals/lancet-oncology/"}]}}