title: Poor-risk germ cell tumors. Recent developments.
abstract: Standard therapy for patients with poor-risk germ cell tumors remains four cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy, which cures approximately 50% of this patient population. Randomized trials of conventional-dose chemotherapy have failed to identify a regimen with superior efficacy to BEP. Preliminary data suggesting efficacy for high-dose chemotherapy with stem cell or autologous bone marrow transplantation as initial therapy for poor-risk disease have led to two randomized trials of this approach as initial therapy for poor-risk patients. The recently developed International Germ Cell Consensus Classification provides a standard method for determining poor-risk status and should be uniformly applied for both clinical decision making and risk assignment in clinical trials.
authors.affiliation: Department of Medical Oncology-Hematology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Dodd
authors.forename: R J
authors.initials: RJ
authors.lastname: Motzer
authors.forename: D F
authors.initials: DF
authors.lastname: Bajorin
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D014408:Biomarkers, Tumor / Q000097:blood; D004334:Drug Administration Schedule; D018237:Germinoma / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D011379:Prognosis; D012306:Risk; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor