title: Update in germ cell tumours.
abstract: OBJECTIVE
  The purpose of this study is to update the reader on advances in postpubertal male germ cell tumours (GCTs) over the last 18 months.
  
  
  RESULTS
  Single nucleotide polymorphisms, including in four sex-determination genes, have been identified as additional genetic susceptibility loci to testicular GCT development. New insights into cisplatin resistance implicate the PDGFR-PIK3CA-AKT and RAS pathways. Circulating tumour cells and circulating microRNAs are potential new biomarkers. In clinical stage I (CS-I) GCT, two large studies have confirmed the excellent outcomes achieved with surveillance, which is now the management option of choice for CS I-A nonseminoma and all CS-I seminomas; CS I-B nonseminoma remains controversial. First-line trials of dose-dense multidrug regimens reported promising results but have not yet supplanted BEPx4. Survivorship issues, including secondary malignancies from chemotherapy, remain important in this disease and are a continuing focus of ongoing research.
  
  
  CONCLUSIONS
  Important research questions remain across all aspects of GCT. The next decade is likely to produce many new and exciting discoveries that will benefit GCT patients.
authors: aGenitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center bDepartment of Medicine, Weill Medical College of Cornell University, New York, New York, USA.
authors: Darren R
authors: DR
authors: Feldman
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D002945:Cisplatin / Q000627:therapeutic use*; D058534:Class I Phosphatidylinositol 3-Kinases; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D009154:Mutation; D019869:Phosphatidylinositol 3-Kinases; D020641:Polymorphism, Single Nucleotide; D051057:Proto-Oncogene Proteins c-akt; D016283:Proto-Oncogene Proteins p21(ras); D018239:Seminoma / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D019869:Phosphatidylinositol 3-Kinases; D058534:Class I Phosphatidylinositol 3-Kinases; C484760:PIK3CA protein, human; C494918:AKT1 protein, human; D051057:Proto-Oncogene Proteins c-akt; C501009:HRAS protein, human; D016283:Proto-Oncogene Proteins p21(ras); D002945:Cisplatin