Real-World Evidence of Treatment Patterns, Time to Real-World Progression, and Overall Survival of Patients With Testicular Germ Cell Tumors Receiving Palliative Chemotherapy in the United States.

INTRODUCTION

Patients with relapsed/refractory (R/R) testicular germ cell tumor (GCT) progressing after salvage chemotherapy only have palliative therapeutic options. Real-world data on this population are needed.

METHODS

Adult men with testicular GCT receiving palliative chemotherapy in the United States were identified in the Komodo Research Database (01/2016-03/2023; index date = date of palliative chemotherapy initiation). Treatment patterns were analyzed for patients with continuous health plan enrollment from diagnosis to index date. Clinical outcomes (time to real-world progression [TTrwP] and real-world overall survival [rwOS]) were assessed among patients with prior salvage chemotherapy using the Kaplan-Meier method.

RESULTS

In the treatment pattern analysis (N = 51; median age 32 years), median (interquartile range) time from diagnosis to first-line treatment was 0.9 (0.5-2.1) months, and to palliative chemotherapy was 12.5 (9.0-16.8) months. Index palliative chemotherapy regimens included gemcitabine-oxaliplatin (37.3%), oral etoposide (15.7%), and gemcitabine-oxaliplatin-paclitaxel (15.7%). Prior to palliative chemotherapy, 33 patients (64.7%) received salvage chemotherapy. In the clinical outcome analysis (N = 80; median age: 33 years), 49 (61.3%) patients were exposed to high-dose chemotherapy (HDCT; ±conventional-dose chemotherapy [CDCT]) and 31 (38.8%) only to CDCT. Overall median (95% confidence interval [CI]) TTrwP was 3.8 (2.6-4.7) months, 3.5 (2.3-4.7) months after HDCT±CDCT, and 4.0 (1.7-6.6) months after only CDCT, and median (95% CI) rwOS was 7.7 (6.3-9.6) months, 6.4 (5.6-9.6) months, and 9.3 (7.5-22.0) months, respectively.

CONCLUSIONS

Real-world data captured heterogeneous treatment patterns and poor outcomes for patients with R/R testicular GCT receiving palliative chemotherapy, highlighting the need for novel therapies.