{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:11:48Z","timestamp":1788894708673,"version":"build-2803163510"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T00:00:00Z","timestamp":1697241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"The NEXT Consortium"},{"DOI":"10.13039\/100002725","name":"\u201cThe Childhood Brain Tumor Foundation\u201d","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100002725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018864","name":"\u201cMaking Headway Foundation\u201d","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018864","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with relapsed intracranial germinoma can achieve durable remission with standard chemotherapy regimens and\/or reirradiation; however, innovative therapies are required for patients with relapsed and\/or refractory intracranial nongerminomatous germ cell tumors (NGGCTs) due to their poor prognosis. Improved outcomes have been reported using reinduction chemotherapy to achieve minimal residual disease, followed by marrow-ablative chemotherapy (HDCx) with autologous hematopoietic progenitor cell rescue (AuHPCR). We conducted a phase II trial evaluating the response and toxicity of a 3-drug combination developed for recurrent intracranial germ cell tumors consisting of gemcitabine, paclitaxel, and oxaliplatin (GemPOx).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 9 patients with confirmed relapsed or refractory intracranial GCT were enrolled after signing informed consent, and received at least 2 cycles of GemPOx, of which all but 1 had relapsed or refractory NGGCTs. One patient with progressive disease was found to have pathologically confirmed malignant transformation to pure embryonal rhabdomyosarcoma (without GCT elements), hence was ineligible and not included in the analysis. Patients who experienced sufficient responses proceeded to receive HDCx with AuHPCR. Treatment response was determined based on radiographic tumor assessments and tumor markers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 7 patients achieved sufficient response and proceeded with HDCx and AuHPCR, and 5 subsequently received additional radiotherapy. A total of 2 patients developed progressive disease while receiving GemPOx. Myelosuppression and transaminitis were the most common treatment-related adverse events. With a mean follow-up of 44 months, 4 patients (3 NGGCTs, 1 germinoma) are alive without evidence of disease.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GemPOx demonstrates efficacy in facilitating stem cell mobilization, thus facilitating the feasibility of both HDCx and radiotherapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/nop\/npad067","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T21:42:20Z","timestamp":1697233340000},"page":"188-198","source":"Crossref","is-referenced-by-count":4,"title":["Final report of the phase II NEXT\/CNS-GCT-4 trial: GemPOx followed by marrow-ablative chemotherapy for recurrent intracranial germ cell tumors"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5821-6216","authenticated-orcid":false,"given":"Margaret","family":"Shatara","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, St. Louis Children\u2019s Hospital, Washington University School of Medicine , St. Louis, Missouri , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Blue","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children\u2019s Hospital and Ohio State University College of Medicine , Columbus, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1630-2102","authenticated-orcid":false,"given":"Joseph","family":"Stanek","sequence":"additional","affiliation":[{"name":"Division of Hematology, Oncology, Blood and Marrow Transplant, Nationwide Children\u2019s Hospital and Ohio State University College of Medicine , Columbus, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin A","family":"Liu","sequence":"additional","affiliation":[{"name":"Departments of Ophthalmology, Neurology, and Neurosurgery, University of California, Davis , Sacramento, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M","family":"Prevedello","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Ohio State University Wexner Medical Center , Columbus, Ohio , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5165-0984","authenticated-orcid":false,"given":"Pierre","family":"Giglio","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Ohio State University Wexner Medical Center, James Cancer Center , Columbus, Ohio , 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Institute, Children\u2019s Hospital Los Angeles and Keck School of Medicine of University of Southern California , Los Angeles, California , USA"},{"name":"Department of Radiation Oncology, University of Southern California , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin D","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Children\u2019s Hospital of Los Angeles , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floyd H","family":"Gilles","sequence":"additional","affiliation":[{"name":"Department of Pathology, Children\u2019s Hospital of Los Angeles , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta H","family":"Adams","sequence":"additional","affiliation":[{"name":"Phoenix Children\u2019s Center for Cancer & Blood Disorders, University of Arizona School of Medicine\u2014Phoenix, and Mayo 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