High-dose chemotherapy and stem cell transplantation for advanced testicular cancer Review uri icon

Overview

MeSH Major

  • Antineoplastic Agents
  • Dose-Response Relationship, Drug
  • Neoplasms, Germ Cell and Embryonal
  • Stem Cell Transplantation
  • Testicular Neoplasms

abstract

  • High-dose chemotherapy (HDCT) with autologous stem cell support has been studied in both the salvage and first-line setting in advanced germ cell tumor (GCT) patients with poor-risk features. While early studies reported significant treatment-related mortality, introduction of peripheral blood stem cell transplantation, recombinant growth factors and better supportive care have decreased toxicity; and in more recent reports treatment-related deaths are observed in <3% of patients. Two to three cycles of high-dose carboplatin and etoposide is the standard backbone for HDCT, given with or without additional agents including ifosfamide, cyclophosphamide and paclitaxel. Three large randomized Phase III trials have failed to show a benefit of HDCT over conventional-dose chemotherapy (CDCT) in the first-line treatment of patients with intermediate- or poor-risk advanced GCT, and to date the routine use of HDCT has been reserved for the salvage setting. Several prognostic models have been developed to help predict outcome of salvage HDCT, the most recent of which applies to both CDCT and HDCT in the initial salvage setting. Patients that relapse after HDCT are usually considered incurable, and additional therapy is provided with palliative intent.

publication date

  • July 2011

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC3253700

Digital Object Identifier (DOI)

  • 10.1586/era.10.231

PubMed ID

  • 21806332

Additional Document Info

start page

  • 1091

end page

  • 103

volume

  • 11

number

  • 7