ABSTRACT Introduction Patients with relapsed/refractory (R/R) testicular germ cell tumor (GCT) progressing after salvage chemotherapy only have palliative therapeutic options. Real‐world data on this population are needed. Methods Adult men with testicular GCT receiving palliative chemotherapy in the United States were identified in the Komodo Research Database (01/2016–03/2023; index date = date of palliative chemotherapy initiation). Treatment patterns were analyzed for patients with continuous health plan enrollment from diagnosis to index date. Clinical outcomes (time to real‐world progression TTrwP and real‐world overall survival rwOS) were assessed among patients with prior salvage chemotherapy using the Kaplan–Meier method. Results In the treatment pattern analysis ( N = 51; median age 32 years), median (interquartile range) time from diagnosis to first‐line treatment was 0.9 (0.5–2.1) months, and to palliative chemotherapy was 12.5 (9.0–16.8) months. Index palliative chemotherapy regimens included gemcitabine‐oxaliplatin (37.3%), oral etoposide (15.7%), and gemcitabine‐oxaliplatin‐paclitaxel (15.7%). Prior to palliative chemotherapy, 33 patients (64.7%) received salvage chemotherapy. In the clinical outcome analysis ( N = 80; median age: 33 years), 49 (61.3%) patients were exposed to high‐dose chemotherapy (HDCT; ±conventional‐dose chemotherapy CDCT) and 31 (38.8%) only to CDCT. Overall median (95% confidence interval CI) TTrwP was 3.8 (2.6–4.7) months, 3.5 (2.3–4.7) months after HDCT±CDCT, and 4.0 (1.7–6.6) months after only CDCT, and median (95% CI) rwOS was 7.7 (6.3–9.6) months, 6.4 (5.6–9.6) months, and 9.3 (7.5–22.0) months, respectively. Conclusions Real‐world data captured heterogeneous treatment patterns and poor outcomes for patients with R/R testicular GCT receiving palliative chemotherapy, highlighting the need for novel therapies.
Feldman et al. (Mon,) studied this question.
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