Darren Feldman, MD, on clinical outcomes in R/R testicular germ cell tumors

In this video, Darren R. Feldman, MD, shares the background and key findings from the study, “Time to real-world progression (TTrwP) among patients (pts) with relapsed/refractory (R/R) testicular germ cell tumors (GCT) undergoing palliative chemotherapy (CT) in the United States (US).” This study was presented at the 2025 American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium in San Francisco, California.

Feldman is a GU medical oncologist, associate attending physician, and section head of the germ cell cancer program within the GU oncology service at Memorial Sloan Kettering Cancer Center in New York, New York.

Video Transcript:

Could you describe the background for this study?

Patients with relapsed/refractory germ cell tumors, which are patients who have progressed, generally after high-dose chemotherapy and stem cell transplant or had 2 or more conventional dose chemotherapy regimens and are not candidates or refuse high-dose chemotherapy. Those patients are considered to have relapsed/refractory disease and are generally considered incurable. This population represents an urgent unmet need. Although it's a small population, these patients are incurable. They have a poor overall prognosis, but they haven't been studied systematically at all, outside of a few expert centers or reporting during clinical trials. The goal of this study was to use real-world data coming from an insurance claim database in the United States, using the Komodo database, which covers about 30% of the US population, to try to characterize this group of patients, which treatments they received, and how their outcome was, and to use that as a benchmark for future clinical trials to improve upon those outcomes.

What were the key findings?

What we looked at previously, and we reported at ASCO 2024 was overall survival of the population. We had found at that time that the overall survival was in the 8-month range, so very short. Overall survival is an absolute defined end point based on actual death records in this insurance claims database.

What we sought to do this time was to evaluate time to progression on their first palliative chemotherapy regimen. That's much harder to do because we don't have in-depth chart reviews, so we had to come up with surrogates for progression. We used things like transition to hospice. We used getting radiation therapy after at least 1 cycle of the palliative chemotherapy regimen, switch in regimens, or discontinuation of regimen, and then ultimately, if there were no surrogates, just death of the patient.

What we found is that, as somewhat expected but very sobering, [was] that the median progression-free survival was under 4 months. It was about 3.8 months. It was low regardless of whether the patient had received high-dose chemotherapy previously, that was about 3.5 months median, or they had only received prior conventional dose chemotherapy, in which it was about 4 months median PFS. It shows the significant poor outcomes in this population with our standard therapies and the need to improve upon that by developing novel treatments.

This transcript was AI generated and edited by human editors for clarity.