High-Dose Chemotherapy for Advanced Germ-Cell Tumors

The introduction of cisplatin-based chemotherapy in the 1970s dramatically improved the outcomes of men with advanced germ-cell tumors. Based on outcomes with this type of therapy, the International Consensus criteria classify patients with germ-cell tumors into good-, intermediate-, and poor-risk groups (J Clin Oncol 1997; 15:594). The cure rates for good- and intermediate-risk patients (80%–90% of all patients) are about 90% and 75%, respectively. Men who relapse after receiving initial cisplatin-based chemotherapy remain potentially curable with salvage regimens that include cisplatin, ifosfamide, and vinblastine or paclitaxel. High-dose chemotherapy with stem-cell rescue as either initial salvage after induction chemotherapy or secondar…