title: A review of second-line chemotherapy and prognostic models for disseminated germ cell tumors.
abstract: Despite an excellent prognosis even for patients with disseminated disease, about 20% to 30% of men with advanced germ cell tumors are refractory to first-line chemotherapy or experience disease recurrence after an initial remission with such treatment. Many of these are cured with conventional dose cisplatin/ifosfamide-based regimen or high-dose chemotherapy with stem cell rescue. Controversy exists regarding the optimal choice between these 2 second-line approaches, and available data for each is reviewed here. Clinical factors can help prognosticate patients, and recently an international effort developed a prognostic model for the second-line setting that can be universally applied in future studies.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Voss
authors.forename: Darren R
authors.initials: DR
authors.lastname: Feldman
authors.forename: George J
authors.initials: GJ
authors.lastname: Bosl
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Motzer
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D016879:Salvage Therapy; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*