Abstract
The majority of patients with advanced germ cell tumours (GCT) achieve a continuous and complete response to first-line cisplatin combination chemotherapy. Nevertheless, patients with poor prognosis respond less well. Moreover, patients with progressive or recurrent GCT require effective salvage therapy. Using conventional-dose chemotherapies in salvage therapy, 20 to 30% of patients will become long-term survivors. Studies of high-dose chemotherapy have reported promising results on its effectiveness in treating recurrent GCT. However, randomized trials do not demonstrate an impact on the clinical benefit of high-dose chemotherapy as a first-line treatment for patients with poor prognosis or recurrent GCT. A better understanding of prognostic factors, the use of new drugs in high-dose protocols and the evaluation of targeted molecular therapies could increase the clinical benefit of high-dose strategies.
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