Chemotherapeutic and surgical strategies for germ cell tumors.
Testicular cancer has become a model for a curable neoplasm. Studies of cisplatin combination chemotherapy performed by the author's group allow the following conclusions: (1) short-duration, intensive induction therapy with the most active agents in optimal dosage is more important than maintenance therapy; (2) a modest dose escalation increases toxicity without improving therapeutic efficacy; (3) it is possible to develop curative salvage therapy for refractory germ cell tumors; and (4) preclinical models predicting synergism, such as vinblastine plus bleomycin or cisplatin plus etoposide, have clinical relevance. Testicular cancer has also become a model for new drug development. Cisplatin has been approved by the US Food and Drug Administration for testis and ovarian cancer and VP-16 and ifosfamide for refractory germ cell tumors. The success of these studies confirms the importance of the continued search for new investigational drugs in all solid tumors.
Einhorn
Lawrence H
LH
Division of Hematology/Oncology, Indiana University Cancer Center, Walther Cancer Institute, Indianapolis, Indiana, USA. leinhorn@iupui.edu
D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D018237:Germinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D009367:Neoplasm Staging / Q000379:methods; D016879:Salvage Therapy / Q000379:methods; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D001761:Bleomycin; D014747:Vinblastine; D005047:Etoposide; D002945:Cisplatin