TIGER: standard-dose TIP versus high-dose TI-CE with stem cell transplant as first salvage for relapsed germ cell tumours
The trial meant to settle a thirty-year argument: whether men whose germ cell tumour comes back after cisplatin should get standard salvage chemotherapy or high-dose chemotherapy with a stem cell transplant.
Overview
Relapsed germ cell tumours are still curable, but retrospective comparisons have long suggested that high-dose chemotherapy with stem cell rescue beats conventional-dose salvage, without a randomised proof. TIGER, run by the Alliance with European cooperative groups, randomises patients at first relapse between four cycles of TIP and the TI-CE high-dose programme. It is active and no longer recruiting, with overall survival as the primary endpoint. Patients with primary mediastinal non-seminoma, the poorest-risk extragonadal group, are among those most in need of the answer.
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