Omar Abughanimeh1, Benjamin A Teply2. 1. Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE, 68198-6840, USA. 2. Division of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE, 68198-6840, USA. ben.teply@unmc.edu.
Abstract
PURPOSE OF REVIEW: Germ cell tumors (GCTs) are the most common solid tumors affecting men between ages of 20 and 34 years. Most of the cases, even in advanced disease, will have good prognosis. However, around 20-30% of advanced disease will be refractory or develop relapse after treatment. Herein, we review the current management of refractory/relapsed GCTs. RECENT FINDINGS: Salvage treatment of GCTs has been a controversial topic for the last few decades. Conventional dose chemotherapy (CDCT), high-dose chemotherapy (HDCT) with stem cell infusion, and surgical salvage were proven to be effective and curative options in some cases. The international randomized trial (TIGER) will ultimately answer which chemotherapy approach may be optimal. Furthermore, the usage of immunotherapy is still under investigation with limited data so far in the setting of relapsed/refractory GCTs. Curative paradigms including with CDCT and HDCT are possible, although novel approaches beyond HDCT are still needed to eliminate mortality from this disease.
PURPOSE OF REVIEW: Germ cell tumors (GCTs) are the most common solid tumors affecting men between ages of 20 and 34 years. Most of the cases, even in advanced disease, will have good prognosis. However, around 20-30% of advanced disease will be refractory or develop relapse after treatment. Herein, we review the current management of refractory/relapsed GCTs. RECENT FINDINGS: Salvage treatment of GCTs has been a controversial topic for the last few decades. Conventional dose chemotherapy (CDCT), high-dose chemotherapy (HDCT) with stem cell infusion, and surgical salvage were proven to be effective and curative options in some cases. The international randomized trial (TIGER) will ultimately answer which chemotherapy approach may be optimal. Furthermore, the usage of immunotherapy is still under investigation with limited data so far in the setting of relapsed/refractory GCTs. Curative paradigms including with CDCT and HDCT are possible, although novel approaches beyond HDCT are still needed to eliminate mortality from this disease.
Authors: Maria G Kier; Jakob Lauritsen; Mette S Mortensen; Mikkel Bandak; Klaus K Andersen; Merete K Hansen; Mads Agerbaek; Niels V Holm; Susanne O Dalton; Christoffer Johansen; Gedske Daugaard Journal: Eur Urol Date: 2016-09-17 Impact factor: 20.096
Authors: S Culine; P Kerbrat; A Kramar; C Théodore; C Chevreau; L Geoffrois; N B Bui; J Pény; A Caty; R Delva; P Biron; K Fizazi; J Bouzy; J P Droz Journal: Ann Oncol Date: 2007-03-09 Impact factor: 32.976
Authors: E C Kohn; G Sarosy; A Bicher; C Link; M Christian; S M Steinberg; M Rothenberg; D O Adamo; P Davis; F P Ognibene Journal: J Natl Cancer Inst Date: 1994-01-05 Impact factor: 13.506