High-Dose Chemotherapy for Patients with Poor-Risk Germ-Cell Tumors

At 51 months, no differences in event-free or overall survival were evident between conventional- and high-dose chemotherapy groups.

Patients with poor-risk germ-cell tumors (as defined by the International Germ Cell Cancer Collaborative Group; J Clin Oncol 1997; 15:594) have a long-term survival rate of about 50%, in contrast to 75% and 90%, respectively, for patients with intermediate- and good-risk germ-cell tumors. Intensification of therapy with multiple active agents and dose intensification of cisplatin, the most active chemotherapy agent for this tumor, have not overcome the inherent drug resistance of poor-risk tumors. However, high-dose chemotherapy with stem-cell rescue has been used successfully as salvage therapy; several phase II trials of initial high-dose chemotherapy for patients with poor prognoses showed that it improved both relapse-free and overall s…

Reviewing Author

Robert Dreicer, MD, MS, FACP