J Cancer 2011; 2:374-377. doi:10.7150/jca.2.374

Review

Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial

Darren R. Feldman1, Robert Huddart2, Emma Hall3, Jörg Beyer4, Thomas Powles5 ✉

1. Genitourinary Oncology Service, Memorial Sloan-Kettering Cancer Center, New York USA
2. Division of Radiotherapy and Imaging, Institute of Cancer Research (ICR), Royal Marsden Hospital, London UK
3. Institute of Cancer Research, Clinical Trials and Statistics Unit (ICR-CTSU), London, UK
4. Director of Oncology, Vivantes Krankenhaus Am Urban, Berlin, Germany
5. Barts Cancer Institute, Queen Mary University of London, London

Abstract

Metastatic germ cell tumours (GCTs) are usually cured with cisplatin based chemotherapy and standard treatment algorithms are established. However when this treatment fails and the disease relapses, standard treatment is much more uncertain. Both conventional dose therapy (CDT) and high dose therapy (HDT) are widely used, due to the lack of conclusive data supporting one specific approach. A recent retrospective analysis focusing on this population suggested a significant benefit for HDT. Retrospective analyses are prone to bias, and therefore while this data is provocative it is by no mean conclusive. For this reason the international community is supporting a prospective randomised trial in this area comparing CDT(TIP) with sequential HDT (TICE). The planned open labelled randomised phase III study (TIGER) is due to open in 2011 and will recruit 390 patients to detect a 13% difference in 2 year progression free survival (primary endpoint). It is hoped that this large study will conclusively resolve the uncertainty which currently exists.

Keywords: Metastatic germ cell tumours, dose therapy, relapses

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How to cite this article:
Feldman DR, Huddart R, Hall E, Beyer J, Powles T. Is High Dose Therapy Superior to Conventional Dose Therapy as Initial Treatment for Relapsed Germ Cell Tumors? The TIGER Trial. J Cancer 2011; 2:374-377. doi:10.7150/jca.2.374. Available from http://www.jcancer.org/v02p0374.htm