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Sir, We read with interest the phase II results presented by Kollmannsberger et al (2002b), which recorded no responses to single-agent irinotecan delivered in a dose of 300–350 mg/m 2 every 3 weeks. This led the authors to conclude that further evaluation of irinotecan in patients with germ cell cancer could not be recommended. We note that other recent single-agent phase II studies in germ cell tumours (oxaliplatin, paclitaxel and gemcitabine (Sandler et al, 1998; Bokemeyer et al, 1999; Kollmannsberger et al, 2002a)) revealed very low objective response rates (Table 1) The patients treated in the studies are invariably heterogenous; however, most have proved refractory to at least two lines of cisplatin-based

Irinotecan in patients with relapsed or cisplatin-refractory germ cell cancer: a phase II study of the German Testicular Cancer Study Group