Good-risk-advanced germ cell tumors: Historical perspective and current standards of care Journal Article


Authors: Feldman, D. R.; Motzer, R. J.
Article Title: Good-risk-advanced germ cell tumors: Historical perspective and current standards of care
Abstract: Outcomes for patients with metastatic germ cell tumors have improved dramatically over the last 30 years with today's cure rates approaching 80%. A critical contribution to the treatment of metastatic disease was the development of the universally accepted international germ cell cancer collaborative group (IGCCCG) outcome prediction model. With this system, patients are classified into good, intermediate, and poor-risk groups, each with a significantly different likelihood of cure. Not only are outcomes more favorable in the good-risk group, the intensity of treatment required to achieve these outcomes is also less. Therefore, the physician's goal in treating good-risk patients is to minimize the short- and long-term therapy-related toxicities, while maintaining the excellent cure rates. Through well-conducted clinical trials, four cycles of etoposide + cisplatin (EP×4) and three cycles of bleomycin + etoposide + cisplatin (BEP×3) have emerged as the two optimal treatment regimens for good-risk patients. Cure rates with either regimen with or without surgery approximate to 90%. Attempts to further diminish the toxicity of either regimen have been unsuccessful due to the resulting reductions in efficacy. The authors discuss the trials which led to the establishment of EP×4 and BEP×3 as today's treatment standards as well as the development of the IGCCCG prognostic model. © Springer-Verlag 2009.
Keywords: review; cisplatin; chemotherapy; cancer staging; antineoplastic agent; neoplasm staging; neoplasm; etoposide; antineoplastic combined chemotherapy protocols; testis tumor; testicular neoplasms; bleomycin; bep protocol; vp p protocol; vp-p protocol; neoplasms, germ cell and embryonal; germ cell tumors; good-risk disease; prognostic models
Journal Title: World Journal of Urology
Volume: 27
Issue: 4
ISSN: 0724-4983
Publisher: Springer  
Date Published: 2009-08-01
Start Page: 463
End Page: 470
Language: English
DOI: 10.1007/s00345-009-0431-z
PUBMED: 19513721
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 30 November 2010" - "Source: Scopus"
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MSK Authors
  1. Robert Motzer
    1023 Motzer
  2. Darren Richard Feldman
    256 Feldman