Pharmacotherapeutic treatment of germ cell tumors - standard of care and recent developments
Standard
Pharmacotherapeutic treatment of germ cell tumors - standard of care and recent developments. / Oing, Christoph; Seidel, Christoph; von Amsberg, Gunhild; Oechsle, Karin; Bokemeyer, Carsten.
In: EXPERT OPIN PHARMACO, Vol. 17, No. 4, 03.2016, p. 545-60.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Pharmacotherapeutic treatment of germ cell tumors - standard of care and recent developments
AU - Oing, Christoph
AU - Seidel, Christoph
AU - von Amsberg, Gunhild
AU - Oechsle, Karin
AU - Bokemeyer, Carsten
PY - 2016/3
Y1 - 2016/3
N2 - INTRODUCTION: Testicular germ cell tumors are the most common malignancy among men aged 40 and less. Since the introduction of cisplatin-based combination chemotherapy, germ cell tumors are among the most curable solid tumors with cure rates of 95% in all patients and > 80% in metastatic disease. Areas covered: Current standards and future developments in GCT treatment, including adjuvant chemotherapy, first line treatment for metastatic disease, and salvage regimens in case of relapse and refractory disease. Expert opinion: Maintaining therapeutic success while further reducing treatment-related toxicity is paramount. Cancer-specific survival in localized disease approximates 100%. Therefore, orchidectomy followed by active surveillance is the preferred approach for all seminomas and non-seminomas lacking lymphovascular invasion. Non-seminomas with lymphovascular invasion should be offered adjuvant treatment with one cycle of BEP. The BEP regimen remains standard of care for metastatic disease, while the role of primary high-dose chemotherapy in case of inadequate tumor-marker decline or presence of high-risk features (i.e. mediastinal origin, non-pulmonary visceral metastases) remains to be elucidated. Several curative salvage chemotherapy combinations are available, i.e. TIP, VeIP, GIP or HD-CE. GOP is the current option of choice in cisplatin-refractory patients. Novel targeted agents failed to improve treatment outcome so far.
AB - INTRODUCTION: Testicular germ cell tumors are the most common malignancy among men aged 40 and less. Since the introduction of cisplatin-based combination chemotherapy, germ cell tumors are among the most curable solid tumors with cure rates of 95% in all patients and > 80% in metastatic disease. Areas covered: Current standards and future developments in GCT treatment, including adjuvant chemotherapy, first line treatment for metastatic disease, and salvage regimens in case of relapse and refractory disease. Expert opinion: Maintaining therapeutic success while further reducing treatment-related toxicity is paramount. Cancer-specific survival in localized disease approximates 100%. Therefore, orchidectomy followed by active surveillance is the preferred approach for all seminomas and non-seminomas lacking lymphovascular invasion. Non-seminomas with lymphovascular invasion should be offered adjuvant treatment with one cycle of BEP. The BEP regimen remains standard of care for metastatic disease, while the role of primary high-dose chemotherapy in case of inadequate tumor-marker decline or presence of high-risk features (i.e. mediastinal origin, non-pulmonary visceral metastases) remains to be elucidated. Several curative salvage chemotherapy combinations are available, i.e. TIP, VeIP, GIP or HD-CE. GOP is the current option of choice in cisplatin-refractory patients. Novel targeted agents failed to improve treatment outcome so far.
U2 - 10.1517/14656566.2016.1127357
DO - 10.1517/14656566.2016.1127357
M3 - SCORING: Journal article
C2 - 26630452
VL - 17
SP - 545
EP - 560
JO - EXPERT OPIN PHARMACO
JF - EXPERT OPIN PHARMACO
SN - 1465-6566
IS - 4
ER -
