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Platinum-refractory germ cell tumors: An update on current treatment options and developments

World Journal of Urology Aug 16, 2017

Oing C, et al. – Aim of this study was to review treatment options and recent establishments in the field of platinum–refractory male germ cell tumors. They found limited treatment options for platinum–refractory disease, but a small subset of patients may achieve long–term disease–free survival by multimodal treatment. The potential of new targeted agents, i.e. by immune–checkpoint–inhibition remains to be characterized.

Methods
  • Researchers performed a comprehensive literature search of PubMed, Medline, Cochrane and Embase distinguish clinical trials regarding the treatment of platinum–refractory disease.
  • They further searched ASCO, EAU and ESMO conference proceedings to distinguish unpublished results of relevant trials.
  • Thereafter, comprehensive review papers were hand searched for additional references. Clinicaltrials.gov was checked for ongoing clinical trials in the field of platinum–refractory germ cell tumors.

Results
  • It was shown that outcome of platinum–refractory disease remains poor.
  • The results confirmed that single–agents with reasonable activity are gemcitabine, oxaliplatin and paclitaxel, but complete remissions resulting in long–term survival could not be achieved.
  • It was revealed that triple–combination of gemcitabine, oxaliplatin and paclitaxel followed by resection of residual masses serves the best outcomes with objective responses in 51 % of patients and long–term survival in approximately 10–15 %. To date, no molecularly targeted agent has shown reasonable activity.
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