Chemotherapy for Germ Cell Tumours in the United States

Abstract

The therapeutic success of chemotherapy for advanced germ cell tumours over the last several decades has resulted in extension of the use of chemotherapy, from a modality used strictly as primary therapy of surgically unresectable disease or disease outside the confines of radiation therapy port, to the modern use which includes consideration of the use of chemotherapy as an adjuvant for fully resected pathological stage II non-seminomatous germ cell tumour, certain rare situations with clinical stage I non-seminoma and of course extension of chemotherapy into a role for secondary therapies after failure of primary chemotherapy. Herein we will review the current standard usage of chemotherapy in the United States as primary therapy for disseminated disease, its use as a post-surgical adjuvant in resected stage II non-seminoma, its rare usage in seropositive clinical stage I non-seminoma and the myriad of salvage chemotherapy approaches for patients with recurrent disease.