{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T17:41:39Z","timestamp":1774460499198,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cisplatin, etoposide, and bleomycin (PEb) have been the standard of care for patients with germ cell tumors (GCT). In the 1990s, an intergroup trial (POG9049\/CCG8882) randomized patients with high\u2010risk GCT, as defined by the 1990 criteria, to high\u2010dose (HDPEb) versus standard\u2010dose PEb. HDPEb resulted in improved event\u2010free survival (EFS), but no difference in overall survival (OS), thus standard\u2010dose PEb has remained the standard of care. Subsequently, the Malignant Germ Cell International Consortium (MaGIC) updated the risk stratification for pediatric and adolescent patients with GCT. Currently, patients are categorized as intermediate or poor risk if they are \u226511\u00a0years of age with Stage IV ovarian GCT, or testicular, mediastinal, or retroperitoneal GCT with intermediate or poor prognosis using the International Germ Cell Consensus Classification criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We re\u2010analyzed data from the POG9049\/CCG8882 trial using the updated MaGIC risk stratification to determine whether HDPEb improved outcomes over PEb in patients with intermediate\/poor\u2010risk GCTs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 299 patients in the trial, 57 patients (48 males, nine females) met the inclusion criteria for this analysis. There were no statistically significant differences in 5\u2010year EFS (0.72 vs. 0.70, <jats:italic>p<\/jats:italic>\u2010value = 0.82) or OS (0.76 vs. 0.74, <jats:italic>p<\/jats:italic>\u2010value = 0.91) among patients treated with HDPEb versus PEb, respectively. Also, of note patients with mediastinal primaries had significantly worse 5\u2010year EFS (0.51 vs. 0.83, <jats:italic>p<\/jats:italic>\u2010value = 0.0062) and OS (0.49 vs. 0.89, <jats:italic>p<\/jats:italic>\u2010value = 0.0013) compared to other sites, with no difference in outcome between HDPEb and PEb.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment with HDPEb did not improve outcomes for intermediate\/poor\u2010risk GCT patients compared to standard\u2010dose PEb.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31665","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T05:04:50Z","timestamp":1742274290000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Standard\u2010Dose Versus High\u2010Dose Cisplatin for Intermediate\/Poor\u2010Risk Extracranial Malignant Germ Cell Tumors: Re\u2010Analysis of Pediatric Oncology Group 9049 and Children's Cancer Group 8882 Trial Using Updated MaGIC Risk Stratification"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0697-6871","authenticated-orcid":false,"given":"Daniel","family":"Prior","sequence":"first","affiliation":[{"name":"Department of Pediatrics Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingye","family":"Yang","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Monrovia California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Monrovia California USA"},{"name":"Department of Population and Public Health Sciences University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7069-0359","authenticated-orcid":false,"given":"Furqan","family":"Shaikh","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4748-8552","authenticated-orcid":false,"given":"A. Lindsay","family":"Frazier","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber\/Boston Children's Cancer and Blood Disorders Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2883-0957","authenticated-orcid":false,"given":"Farzana","family":"Pashankar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(15)00545\u20108"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejm198706043162302"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.3369"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11271"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.1998.16.2.692"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.0171"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1023\/a:1008279222625"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.8461"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6602830"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.4528"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2006.10.035"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq575"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.08.015"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.21218"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1997.15.2.594"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/2281868"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.04.1251"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.1999.17.4.1212"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.16.4202"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.24601"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.06.034"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2016.66.7899"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.36.15_suppl.4508"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1470\u20102045(14)70490\u20105"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.23.01960"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30562"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt369"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2011.309"},{"key":"e_1_2_9_30_1","unstructured":"\u201cAccelerated V's Standard Bep Chemotherapy for Patients With Intermediate and Poor\u2010Risk Metastatic Germ Cell Tumours (P3bep) \u201d ClinicalTrialsgov 2015 accessed May 15 2024 https:\/\/www.clinicaltrials.gov\/study\/NCT02582697?cond=NCT02582697&rank=1."},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2002.07.062"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31667"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.31665","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T10:27:57Z","timestamp":1745404077000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.31665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/pbc.31665"],"URL":"https:\/\/doi.org\/10.1002\/pbc.31665","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"assertion":[{"value":"2024-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e31665"}}