Recent advances in the biology of germ cell tumors: implications for the diagnosis and treatment.

Testicular germ cell tumors (TGCT), are the most frequent solid malignant tumors in men 20-40 yr of age, and the most frequent cause of death from solid tumors in this age group. TGCT can be subdivided into seminoma and nonseminoma germ cell tumors (NSGCT), including embryonal cell carcinoma, choriocarcinoma, yolk sac tumor, and teratoma. Seminomas and NSGCT do not only present distinctive clinical features, but they also show significant differences as far as therapy and prognosis are concerned. Many novel markers have given further advantages to discriminate between histological subgroups. In addition, therapeutic approaches for the treatment of TGCT have been proposed: humanized antibodies against receptors/surface molecules on cancer cells, inhibitors of serine-threonine, and tyrosine kinases, and others. The review will focus on the recent advances in the research of molecular alterations identified in TGCT and on novel targeted anti-neoplastic strategies that might help to treat chemotherapy-resistant TGCT.