{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:06:55Z","timestamp":1784002015343,"version":"3.55.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Somatic-type malignancy (SM) of germ cell tumor (GCT) is rare but demonstrates aggressive behavior. Differences by primary site, time to transformation, and mutational status remain poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We reviewed all SM patients between June 2016 and May 2025 at a tertiary referral center. Time to somatic transformation (TST) was defined from the initial GCT diagnosis to SM detection. SM were classified based on time of detection- at initial diagnosis (de novo), at consolidative surgery, at relapse within 5\u2009years, and evolved SM at relapse after 5\u2009years. Descriptive statistics, Kaplan-Meier estimates, and Cox regression analyses were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>72 patients were identified: 40 (56%) with testicular, 24 (33%) with mediastinal, and 8 (11%) with other primaries. 22\/24 (92%) mediastinal tumors with SM had sarcomatous transformation. Sarcoma was seen in 25\/42 (60%) of de novo SM while adenocarcinoma was detected as an evolved entity in 5\/6 (83.3%) cases. Embryonic type neuroectodermal tumor (ENET) histology carried poor prognosis compared to non-ENET histology (median, OS 1.8 vs 8\u2009years; HR, 1.94; P\u2009=\u20090.1). Genomic data available showed PTEN-AKT-mTOR pathway mutations (33%) and TP53 mutations (33%), enriched in extra-gonadal sarcomatous SM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SM exhibits temporal, histologic, and molecular distinctions across primary sites. Response to frontline therapy and survival outcomes are poor. Future direction includes the exploration of underlying predictors of transformation and identification of targetable alterations in the relapsed setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag253","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:02:38Z","timestamp":1782856958000},"source":"Crossref","is-referenced-by-count":0,"title":["Divergent biology and outcomes of somatic transformations in germ cell tumors"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1534-5397","authenticated-orcid":false,"given":"Zachariah","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C","family":"Johns","sequence":"additional","affiliation":[{"name":"Department of 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The University of Texas MD Anderson Cancer Center , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungtaek L","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of GU Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amishi Y","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX 77030,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX 77030,","place":["United 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