title: Third-line chemotherapy and novel agents for metastatic germ cell tumors.
abstract: Although germ cell tumors (GCT) are among the most curable solid tumors, a subset of patients with GCT experience relapse or progression despite appropriate cisplatin-based therapy or first-line salvage therapy. This article describes the molecular mechanisms of cisplatin resistance, outlines single-agent chemotherapy and combination chemotherapy regimens that are active against GCT in the third-line or later setting, discusses the use of drug therapy for treating growing teratoma syndrome and teratoma with malignant transformation, outlines novel agents used to treat GCT, and highlights ongoing clinical trials and future directions in the treatment of refractory GCT.
authors.affiliation: Division of Hematology/Oncology, University of Pennsylvania, 16 Penn Tower, 3400 Spruce, Philadelphia, PA 19104, USA. christine.veenstra@uphs.upenn.edu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Veenstra
authors.forename: David J
authors.initials: DJ
authors.lastname: Vaughn
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D019008:Drug Resistance, Neoplasm / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology
chemical_list: D002945:Cisplatin