title: Salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) in relapsed or cisplatin-refractory germ cell tumors.
abstract: BACKGROUND
  In relapsed germ cell tumors, salvage chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) is a well-established regimen for patients with favorable features such as a primary testicular tumor and prior complete remission (CR) after the initial chemotherapy. We reviewed patients who had received salvage TIP chemotherapy, and evaluated the efficacy of TIP, linking it to patient characteristics.
  
  
  METHODS
  Between August 1998 and May 2009, a total of 14 patients were treated with salvage TIP chemotherapy. 10 of 14 had cisplatin-refractory disease, and none of the patients were expected to show a favorable outcome to conventional-dose salvage chemotherapy.
  
  
  RESULTS
  Of the 14 patients, 5 (37.5%) showed a favorable response (CR in 1 patient, partial response (PR) in 4 patients) to TIP alone, and 1 had CR with subsequent surgery after TIP. 2 patients with CR and another 2 patients who attained disease stabilization are still alive at 81.3, 25.4, 69.3, and 27.4 months, respectively. After a median follow-up of 41.0 months (range 11.1-137.6), the median overall survival time for all patients was 21.1 (range 5.0-112.6).
  
  
  CONCLUSIONS
  Even in the presence of poor prognostic features, salvage TIP chemotherapy can be an active regimen in patients with relapsed or refractory germ cell tumors.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Silvia
authors.initials: S
authors.lastname: Park
authors.forename: Soohyeon
authors.initials: S
authors.lastname: Lee
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Joon Oh
authors.initials: JO
authors.lastname: Park
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Kang
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Park
authors.forename: Ho Yeong
authors.initials: HY
authors.lastname: Lim
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D002945:Cisplatin / Q000008:administration & dosage* / Q000633:toxicity; D018450:Disease Progression; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D019008:Drug Resistance, Neoplasm; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000633:toxicity; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000633:toxicity; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D018239:Seminoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D055815:Young Adult
chemical_list: D017239:Paclitaxel; D002945:Cisplatin; D007069:Ifosfamide