Treatment intensification in disseminated germ-cell tumors.
Despite major improvements in the treatment of germ cell tumors the results remain unsatisfactory in patients with "poor risk" initial presentation, with inadequately responding or relapsed disease. The alternating use of noncrossresistant drugs or dose-intensified treatment regimens have not proved to be superior to conventional regimens, although the role of early treatment intensification with the use of hematopoetic growth factors or hematopoetic stem cell reinfusion warrants further investigation. In phase I/II trials patients considered incurable with conventional treatment regimens have been successfully salvaged by high-dose chemotherapy and autologous stem cell reinfusion. Several phase III trials to define the role of this novel approach are planned or ongoing in the USA and Europe.
Beyer
J
J
Abteilung für Hämatologie/Onkologie, Universitätsklinikum Rudolf Virchow der Freien Universität Berlin, Germany.
Bokemeyer
C
C
Schmoll
H J
HJ
Siegert
W
W
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D018237:Germinoma / Q000188:drug therapy* / Q000556:secondary* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D016879:Salvage Therapy; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000628:therapy