Outcome of Children With Intermediate-Risk Extracranial Malignant Germ Cell Tumors by Response Status at the End of Induction Chemotherapy: A Report From the Children’s Oncology Group

Fonseca A, Villaluna D, Krailo M, Olson TA, Pashankar F, Malogolowkin MH, Amatruda JF, Billmire DF, Rescorla FJ, Ross JH, Dicken BJ, Rodriguez-Galindo C, Frazier L, Shaikh F. Outcome of Children With Intermediate-Risk Extracranial Malignant Germ Cell Tumors by Response Status at the End of Induction Chemotherapy: A Report From the Children’s Oncology Group. Pediatr Blood Cancer. 2025 Dec;72(12):e32033. doi: 10.1002/pbc.32033. Epub 2025 Sep 14. PMID: 40947516; PMCID: PMC13086527.

In many pediatric malignant germ cell tumor (MGCT) protocols, patients who do not achieve a complete response (CR; normal tumor markers, no radiological/histological residual) after three cisplatin–etoposide–bleomycin (PEb) cycles receive two to three “consolidation” cycles of the same regimen. Evidence for this practice is limited, and historical outcomes for non-CR patients remain poor. We retrospectively reviewed patients diagnosed with intermediate-risk MGCT, enrolled in AGCT0132, between 2003 and 2011. All patients received three cycles of PEb and underwent response assessment at the end of induction. Patients not in CR were prescribed three additional cycles of PEb as consolidation. We compared event-free survival (EFS) and overall survival (OS) for patients who did and did not receive consolidation.