IT-94: conventional-dose versus high-dose salvage
After relapse following first-line chemotherapy for germ-cell tumours, does adding a single high-dose chemotherapy consolidation after conventional salvage improve survival?
Histology scope: Mixed GCT · randomized second-line study. This is not a seminoma-only efficacy estimate.
Reported outcomes
IT-94 compared four cycles of conventional-dose VIP/VeIP with three cycles followed by high-dose carboplatin/etoposide/cyclophosphamide and stem-cell support. Response rates were similar (about 56%); 3-year event-free survival was 35% versus 42% (P=.16), without a demonstrated significant survival benefit from the high-dose strategy.
Source-reported values only. NNT is not applicable to this single-arm or non-randomized evidence.
Interpretation and guideline context
ESMO–EURACAN 2022 lists standard-dose VIP/PEI, TIP or VeIP among first-salvage options after relapse. NCCN Testicular Cancer Guidelines Insights Version 2.2025 is linked as a contemporary guideline source. Neither guideline converts mixed-histology cohorts into seminoma-specific evidence.
Primary source
Pico JL, Rosti G, Kramar A, et al. A randomised trial of high-dose chemotherapy in the salvage treatment of patients failing first-line platinum chemotherapy for advanced germ cell tumours. Ann Oncol. 2005;16:1152–1159.
Evidence review date: 18 October 2026. Full clinical freshness and browser-rendered visual QA remain pending.