Table 8.

Summary of randomized studies in advanced germ cell tumours

Author	Year	Risk stratification	No. patients	Treatment	Results
Good-risk patients
Bosl106	1988	MSKCC	164	EP × 4 VABcCy × 4	No difference EP less toxic
Einhorn98	1989	Indiana	184	BEP × 3 BEP × 4	No difference BEP × 3 less toxic
de Wit99	2001	MRC/EORTC	812	BEP × 3 BEP × 4	No difference BEP × 3 less toxic 5 days less toxic vs. 3 days
Culine100	2007	Institut Gustave Roussy	262	BEP × 3 EP × 4	Equivalent RR Survival underpowered
Role of bleomycin in good-risk patients
Levi194	1993	AGCTG	218	PVP VP	Equivalent RR but less cancer deaths with PVB
Loehrer105	1995	Indiana	171	BEP × 3 EP × 3	BEP × 3 superior
de Wit195	1997	IGCCC	395	BE360P × 4 E360P × 4	BE360P × 4 superior
Culine100	2007	Institut Gustave Roussy	262	BEP × 3 EP × 4	Equivalent RR Survival underpowered
Role of carboplatin
Bajorin103	1993	MSKCC Good Risk	265	EP × 4 E Carbo × 4	EP × 4 superior
Horowich102	1997	MRC/EORTC Good Risk	598	BE360P × 4 BE360Carbo × 4	BE360P × 4 superior
Intermediate and poor risk
Nichols108	1998	Indiana Advanced (= IGCCC-intermediate and poor)	304	BEP × 4 VIP × 4	No difference BEP × 4 less toxic
de Wit110	1998	IGCCC (good, intermediate, poor)	84	BEP × 4 VIP × 4	No difference (closed early)
Droz112	2007	IGCCC (intermediate, poor)	114	PVeB × 4 HDCT	No difference
Motzer111	2007	IGCCC (intermediate, poor)	219	BEP × 4 HDCT	No difference

MSKCC = Memorial Sloan-Kettering Cancer Center; EP = etoposide and cisplatin; VABcCy = vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin;

BEP = bleomycin, etoposide, platinum; RR = response rate; MRC = Mediacl Research Council; EORTC = European Organization for Research and Treatment of Cancer;

AGCTG = Australasian Germ Cell Trial Group; IGCCC = International Germ Cell Consensus Classification; PVP = polyvinylpyrrolidone; VP = etoposide ; E Carbo = etoposide and carboplatin;

BE Carbo = bleomycin, etoposide and carboplatin; VIP = cisplatin; PVB = cisplatin [platinol-AQ], vinblastine, bleomycin.