Treatment of patients with relapsed and/or cisplatin-refractory metastatic germ cell tumours: an update.
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Treatment of patients with relapsed and/or cisplatin-refractory metastatic germ cell tumours: an update. / Koychev, Daniel; Oechsle, Karin; Bokemeyer, Carsten; Honecker, Friedemann.
In: INT J ANDROL, Vol. 34, No. 4 Pt 2, 4 Pt 2, 01.08.2011, p. 266-273.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Treatment of patients with relapsed and/or cisplatin-refractory metastatic germ cell tumours: an update.
AU - Koychev, Daniel
AU - Oechsle, Karin
AU - Bokemeyer, Carsten
AU - Honecker, Friedemann
N1 - © 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.
PY - 2011/8/1
Y1 - 2011/8/1
N2 - Since the introduction of cisplatin-based therapy in the late 1970s, germ cell tumours (GCT) have been one of the successes in oncology with high cure rates even in patients presenting with metastatic disease. For patients with relapse after cisplatin-based therapy, treatment is still curative in approximately 50% of the cases. Management options for these patients include surgery, radiotherapy and use of conventional dose or high-dose chemotherapy (HDCT). Therefore, treatment of relapsed or refractory patients is complex and there is no uniformly accepted approach available. Data comparing conventional dose and HDCT in the first salvage therapy is limited to one randomized trial which was not able to ultimately define optimal treatment. More recently, a large retrospective analysis of nearly 1600 patients not only identified prognostic factors in relapse, but retrospectively suggested a 10-15% benefit regarding overall survival for patients receiving HDCT plus autologous stem cell transplantation over patients receiving conventional-dose chemotherapy. Prognosis in multiply relapsed and primary cisplatin-refractory patients is generally poor. Currently, a number of mechanisms of cisplatin resistance and potential drug targets like global methylation and BRAF mutation status are under investigation in refractory GCT.
AB - Since the introduction of cisplatin-based therapy in the late 1970s, germ cell tumours (GCT) have been one of the successes in oncology with high cure rates even in patients presenting with metastatic disease. For patients with relapse after cisplatin-based therapy, treatment is still curative in approximately 50% of the cases. Management options for these patients include surgery, radiotherapy and use of conventional dose or high-dose chemotherapy (HDCT). Therefore, treatment of relapsed or refractory patients is complex and there is no uniformly accepted approach available. Data comparing conventional dose and HDCT in the first salvage therapy is limited to one randomized trial which was not able to ultimately define optimal treatment. More recently, a large retrospective analysis of nearly 1600 patients not only identified prognostic factors in relapse, but retrospectively suggested a 10-15% benefit regarding overall survival for patients receiving HDCT plus autologous stem cell transplantation over patients receiving conventional-dose chemotherapy. Prognosis in multiply relapsed and primary cisplatin-refractory patients is generally poor. Currently, a number of mechanisms of cisplatin resistance and potential drug targets like global methylation and BRAF mutation status are under investigation in refractory GCT.
KW - Humans
KW - Male
KW - Prognosis
KW - Recurrence
KW - Salvage Therapy
KW - Antineoplastic Agents/therapeutic use
KW - Cisplatin/therapeutic use
KW - Neoplasms, Germ Cell and Embryonal/drug therapy/therapy
KW - Testicular Neoplasms/drug therapy/therapy
KW - Humans
KW - Male
KW - Prognosis
KW - Recurrence
KW - Salvage Therapy
KW - Antineoplastic Agents/therapeutic use
KW - Cisplatin/therapeutic use
KW - Neoplasms, Germ Cell and Embryonal/drug therapy/therapy
KW - Testicular Neoplasms/drug therapy/therapy
U2 - 10.1111/j.1365-2605.2011.01145.x
DO - 10.1111/j.1365-2605.2011.01145.x
M3 - SCORING: Journal article
C2 - 21790652
VL - 34
SP - 266
EP - 273
IS - 4 Pt 2
M1 - 4 Pt 2
ER -