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Titel: First-line salvage treatment options for germ cell tumor patients failing stage-adapted primary treatment : A comprehensive review compiled by the German Testicular Cancer Study Group
VerfasserIn: Pfister, David
Oechsle, Karin
Schmidt, Stefanie
Busch, Jonas
Bokemeyer, Carsten
Heidenreich, Axel
Heinzelbecker, Julia
Ruf, Christian
Winter, Christian
Zengerling, Friedemann
Kliesch, Sabine
Albers, Peter
Oing, Christoph
Sprache: Englisch
Titel: World Journal of Urology
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2022
Freie Schlagwörter: Germ cell tumor
Relapse
Salvage treatment
High-dose chemotherapy
Salvage surgery
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Purpose In this review, we summarize and discuss contemporary treatment standards and possible selection criteria for decision making after failure of adjuvant or first-line cisplatin-based chemotherapy for primarily localized or metastatic germ cell tumors. Methods This work is based on a systematic literature search conducted for the elaboration of the first German clinical practice guideline to identify prospective clinical trials and retrospective comparative studies published between Jan 2010 and Feb 2021. Study end points of interest were progression-free (PFS) and overall survival (OS), relapse rate (RR), and/or safety. Results Relapses of clinical stage I (CS I) patients irrespective of prior adjuvant treatment after orchiectomy are treated stage adapted in accordance for primary metastatic patients. Surgical approaches for sole retroperitoneal relapses are investigated in ongoing clinical trials. The appropriate salvage chemotherapy for metastatic patients progressing or relapsing after first-line cisplatin-based chemotherapy is still a matter of controversy. Conventional cisplatin-based chemotherapy is the international guideline-endorsed standard of care, but based on retrospective data high-dose chemotherapy and subsequent autologous stem cell transplantation may offer a 10–15% survival benefit for all patients. Secondary complete surgical resection of all visible residual masses irrespective of size is paramount for treatment success. Conclusions Patients relapsing after definite treatment of locoregional disease are to be treated by stage-adapted first-line standard therapy for metastatic disease. Patients with primary advanced/metastatic disease failing one line of cisplatin-based combination chemotherapy should be referred to GCT expert centers. Dose intensity is a matter of ongoing debate, but sequential high-dose chemotherapy seems to improve patients’ survival.
DOI der Erstveröffentlichung: 10.1007/s00345-022-03959-8
URL der Erstveröffentlichung: https://link.springer.com/article/10.1007/s00345-022-03959-8
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-377028
hdl:20.500.11880/34105
http://dx.doi.org/10.22028/D291-37702
ISSN: 1433-8726
0724-4983
Datum des Eintrags: 25-Okt-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Urologie und Kinderurologie
Professur: M - Prof. Dr. Michael Stöckle
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons Creative Commons