Current medical management of patients with poor-risk metastatic germ-cell tumors

Costantine Albany

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Purpose of review Despite the high cure rate of germ-cell tumors (GCTs), the 5-year survival rate for those patients with metastatic poor-risk GCT rarely exceeds 50%. The purpose of this review is to highlight past and recent discoveries in the treatment of patients with poor-risk GCT. Recent findings Multiple clinical trials to optimize the management of poor-risk germ-cell cancer are ongoing. First-line phase II clinical trials of dose-dense multidrug and paclitaxel-based regimens such as accelerated bleomycin, etoposide, and cisplatin (BEP), dose-dense chemotherapy and paclitaxel, ifosfamide, and cisplatin (TIP) reported promising results. Positive phase III data are still lacking. Summary Four cycles of BEP or Etoposide (VP16), ifosfamide, cisplatin (VIP) continue to be the standard of care in patients with poor-risk GCT. A significant disparity in patient outcome exists between high-volume and low-volume centers. Referral for centers of excellence should be considered in the management of poor-risk GCT.

Original languageEnglish (US)
Pages (from-to)474-478
Number of pages5
JournalCurrent Opinion in Urology
Volume28
Issue number5
DOIs
StatePublished - Jan 1 2018

Fingerprint

Germ Cell and Embryonal Neoplasms
Etoposide
Cisplatin
Ifosfamide
Bleomycin
Risk Management
Phase II Clinical Trials
Standard of Care
Paclitaxel
Referral and Consultation
Survival Rate
Clinical Trials
Drug Therapy

Keywords

  • Cisplatin
  • Germ-cell tumor
  • International Germ Cell Consensus Classification Group
  • Poor-risk
  • Primary mediastinal nonseminoma

ASJC Scopus subject areas

  • Urology

Cite this

Current medical management of patients with poor-risk metastatic germ-cell tumors. / Albany, Costantine.

In: Current Opinion in Urology, Vol. 28, No. 5, 01.01.2018, p. 474-478.

Research output: Contribution to journalReview article

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abstract = "Purpose of review Despite the high cure rate of germ-cell tumors (GCTs), the 5-year survival rate for those patients with metastatic poor-risk GCT rarely exceeds 50{\%}. The purpose of this review is to highlight past and recent discoveries in the treatment of patients with poor-risk GCT. Recent findings Multiple clinical trials to optimize the management of poor-risk germ-cell cancer are ongoing. First-line phase II clinical trials of dose-dense multidrug and paclitaxel-based regimens such as accelerated bleomycin, etoposide, and cisplatin (BEP), dose-dense chemotherapy and paclitaxel, ifosfamide, and cisplatin (TIP) reported promising results. Positive phase III data are still lacking. Summary Four cycles of BEP or Etoposide (VP16), ifosfamide, cisplatin (VIP) continue to be the standard of care in patients with poor-risk GCT. A significant disparity in patient outcome exists between high-volume and low-volume centers. Referral for centers of excellence should be considered in the management of poor-risk GCT.",
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