Pharmacotherapy of relapsed metastatic testicular cancer.
BACKGROUND
Patients with metastatic testicular cancer exhibit an excellent prognosis. However, the outcome for patients with relapse after cisplatin-based chemotherapy remains unsatisfactory. Several larger studies have been recently published.


OBJECTIVE
To review the treatment of patients with testicular cancer after failure of first-line chemotherapy.


METHODS
A literature search was performed for studies investigating therapies for relapsed testicular cancer.


CONCLUSIONS
The prognosis of patients relapsing after first-line cisplatin-based chemotherapy has improved with multimodality therapy, including conventional and high-dose chemotherapy, surgery and radiation. Prognostic factors are increasingly used to guide treatment intensity. High-dose chemotherapy has become an accepted treatment option, in particular in patients with poor risk factors at relapse. The outcome of patients with multiply relapsed or cisplatin-refractory disease remains particularly poor. Treatment of relapsed patients requires a close cooperation of medical oncologists, urologists, surgeons and radiation oncologists with extensive experience in this disease.
Kollmannsberger
C
C
British Columbia Cancer Agency/University of British Columbia-Vancouver Cancer Centre, Division of Medical Oncology, 600 West 10th Avenue, Vancouver, BC V5Z4E6, Canada. ckollmannsberger@bccancer.bc.ca
Honecker
F
F
Bokemeyer
C
C
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D011379:Prognosis; D012008:Recurrence; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017211:Treatment Failure
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D002945:Cisplatin