{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:53:23Z","timestamp":1781585603603,"version":"3.54.5"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Following promising results in a phase II trial evaluating GAMMA as salvage therapy for relapsed germ cell tumours (GCT) who had progressed on cisplatin\u2010based chemotherapy, the GAMMA regimen was adopted into clinical practice at St Bartholomew's Hospital. This study provides the largest real\u2010world evaluation of the GAMMA regimen to date, assessing its long\u2010term effectiveness in an unselected patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>This was a single\u2010centre retrospective study of patients who progressed following cisplatin\u2010based chemotherapy and were treated with GAMMA regimen between November 2012 and September 2023. Data collected included clinico\u2010pathological features, treatment details and prognostic risk scores which are International Germ Cell Cancer Collaborative Group (IGCCCG) risk classification and International Prognostic Factor Study Group (IPFSG) score. Progression\u2010free survival (PFS), overall survival (OS) and objective response rate (ORR) were assessed. Survival was estimated using the Kaplan\u2013Meier method and compared using the log\u2010rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 69 patients were included with a median age of 39\u2009years. Most were male (94%) and had an ECOG performance status of 0\u20131 (76%). Non\u2010seminomatous histology was observed in 80% and 74% had a gonadal primary tumour. BEP was the most common first\u2010line treatment (89%). Poor\u2010risk disease per IGCCCG criteria was seen in 41% while 39% were intermediate\u2010risk by IPFSG. 64% completed all planned chemotherapy cycles; 10% discontinued due to toxicity. Stem cell mobilisation was successful in 91%. The most frequent treatment response was partial response marker negative (PRm\u2010) (38%). The 2\u2010year PFS and OS rates were 31% and 49%, respectively. By IPFSG risk group, 2\u2010year PFS and OS ranged from 20%\u201350% and 20%\u201375%. Among patients with LDH \u2265\u20092.5xULN, 2\u2010year PFS was 38% and OS was 47%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>GAMMA demonstrates acceptable tolerability and maintains meaningful survival outcomes, supporting its use as a dose\u2010intensified salvage treatment option for patients with relapsed GCT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71964","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:10:13Z","timestamp":1779250213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes of the Alternative\n                    <scp>GAMMA<\/scp>\n                    Regimen in Relapsed Germ Cell Tumours"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7578-5792","authenticated-orcid":false,"given":"Nasreen Abdul","family":"Aziz","sequence":"first","affiliation":[{"name":"School of Medicine, School of Postgraduate Studies, Royal College of Surgeons in Ireland  Dublin Ireland"},{"name":"St Bartholomew's Hospital, Barts Health NHS Trust  London UK"},{"name":"Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9132-4075","authenticated-orcid":false,"given":"Kenrick","family":"Ng","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabhakar","family":"Rajan","sequence":"additional","affiliation":[{"name":"St Bartholomew's Hospital, Barts Health NHS Trust  London 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