{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:03:38Z","timestamp":1784199818214,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100032339","name":"BioNTech","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100032339","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients with relapsed\/refractory (R\/R) testicular germ cell tumor (GCT) progressing after salvage chemotherapy only have palliative therapeutic options. Real\u2010world data on this population are needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult men with testicular GCT receiving palliative chemotherapy in the United States were identified in the Komodo Research Database (01\/2016\u201303\/2023; index date\u2009=\u2009date 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\u2010world progression [TTrwP] and real\u2010world overall survival [rwOS]) were assessed among patients with prior salvage chemotherapy using the Kaplan\u2013Meier method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the treatment pattern analysis (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200951; median age 32\u2009years), median (interquartile range) time from diagnosis to first\u2010line treatment was 0.9 (0.5\u20132.1) months, and to palliative chemotherapy was 12.5 (9.0\u201316.8) months. Index palliative chemotherapy regimens included gemcitabine\u2010oxaliplatin (37.3%), oral etoposide (15.7%), and gemcitabine\u2010oxaliplatin\u2010paclitaxel (15.7%). Prior to palliative chemotherapy, 33 patients (64.7%) received salvage chemotherapy. In the clinical outcome analysis (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200980; median age: 33\u2009years), 49 (61.3%) patients were exposed to high\u2010dose chemotherapy (HDCT; \u00b1conventional\u2010dose chemotherapy [CDCT]) and 31 (38.8%) only to CDCT. Overall median (95% confidence interval [CI]) TTrwP was 3.8 (2.6\u20134.7) months, 3.5 (2.3\u20134.7) months after HDCT\u00b1CDCT, and 4.0 (1.7\u20136.6) months after only CDCT, and median (95% CI) rwOS was 7.7 (6.3\u20139.6) months, 6.4 (5.6\u20139.6) months, and 9.3 (7.5\u201322.0) months, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Real\u2010world data captured heterogeneous treatment patterns and poor outcomes for patients with R\/R testicular GCT receiving palliative chemotherapy, highlighting the need for novel therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72017","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:25:23Z","timestamp":1781234723000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Evidence of Treatment Patterns, Time to Real\u2010World Progression, and Overall Survival of Patients With Testicular Germ Cell Tumors Receiving Palliative Chemotherapy in the United States"],"prefix":"10.1002","volume":"15","author":[{"given":"Darren R.","family":"Feldman","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Gagnon\u2010Sanschagrin","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc.  Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6804-319X","authenticated-orcid":false,"given":"Jessica","family":"Maitland","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc.  Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Yokoji","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc.  Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Gu\u00e9rin","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc.  Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Guan","sequence":"additional","affiliation":[{"name":"BioNTech  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Joseph","sequence":"additional","affiliation":[{"name":"BioNTech  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21819"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-014-1361-y"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.03296"},{"key":"e_1_2_12_5_1","unstructured":"The Surveillance Epidemiology and End Results (SEER) Program Cancer Stat Facts: Testicular Cancer National Cancer Institute 2024available from https:\/\/seer.cancer.gov\/statfacts\/html\/testis.html."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2019.1583745"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.annonc.a010473"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.2.512"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.07.7271"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.2.509"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.06.068"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.66000524"},{"issue":"1","key":"e_1_2_12_13_1","first-page":"36","article-title":"Phase II Study of Daily Oral Etoposide in Refractory Germ Cell Tumors","volume":"17","author":"Miller J. C.","year":"1990","journal-title":"Seminars in Oncology"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdm526"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26375"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68305-0"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2021.1838279"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SPC.0b013e328309c741"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2020.09.013"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2009.12.529"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdi228"},{"key":"e_1_2_12_22_1","unstructured":"ClinicalTrials.gov NCT02375204. Standard\u2010Dose Combination Chemotherapy or High\u2010Dose Combination Chemotherapy and Stem Cell Transplant in Treating Patients With Relapsed or Refractory Germ Cell Tumors 2025available from https:\/\/clinicaltrials.gov\/study\/NCT02375204."},{"key":"e_1_2_12_23_1","unstructured":"National Comprehensive Cancer Network Inc. 2025. All Rights Reserved. Referenced With Permission From the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Testicular Cancer V.1 2025.accessed February 14 2025 https:\/\/www.nccn.org\/."},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.08.767"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2017.021683"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.01.002"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu506"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.19.00013"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.1586"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72017","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.72017","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.72017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:03:39Z","timestamp":1784196219000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.72017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/cam4.72017"],"URL":"https:\/\/doi.org\/10.1002\/cam4.72017","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72017"}}