High-dose chemotherapy and stem cell transplantation for advanced testicular cancer Journal Article


Authors: Voss, M. H.; Feldman, D. R.; Motzer, R. J.
Article Title: High-dose chemotherapy and stem cell transplantation for advanced testicular cancer
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. © 2011 Expert Reviews Ltd.
Keywords: cancer chemotherapy; cancer survival; overall survival; drug tolerability; review; salvage therapy; cisplatin; advanced cancer; dose response; drug efficacy; drug potentiation; drug safety; recommended drug dose; unspecified side effect; antineoplastic agents; paclitaxel; chemotherapy; drug megadose; carboplatin; progression free survival; multiple cycle treatment; bone marrow suppression; etoposide; bleeding; cyclophosphamide; stem cell transplantation; dose-response relationship, drug; ifosfamide; vinblastine; drug dose escalation; febrile neutropenia; disease progression; testicular neoplasms; bleomycin; testicular cancer; neoplasms, germ cell and embryonal; sensory dysfunction; testis cancer; germ cell tumor; germ cell tumors; high-dose chemotherapy; peripheral nerve injury; oxazaphosphorine
Journal Title: Expert Review of Anticancer Therapy
Volume: 11
Issue: 7
ISSN: 1473-7140
Publisher: Taylor & Francis Group  
Date Published: 2011-07-01
Start Page: 1091
End Page: 1103
Language: English
DOI: 10.1586/era.10.231
PROVIDER: scopus
PUBMED: 21806332
PMCID: PMC3253700
DOI/URL:
Notes: --- - "Export Date: 3 October 2011" - "CODEN: ERATB" - "Source: Scopus"
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MSK Authors
  1. Robert Motzer
    1084 Motzer
  2. Darren Richard Feldman
    275 Feldman
  3. Martin Henner Voss
    233 Voss