Salvage Chemotherapy and Autologous Bone Marrow Chemotherapy for Refractory Germ Cell Malignancies

Abstract

This chapter describes salvage chemotherapy and autologous bone marrow chemotherapy for refractory germ cell malignancies. In a study conducted by a group in the refractory patients, a 29% complete response rate was achieved among 51 patients treated with the drug combination etoposide, dactinomycin and methotrexate. None of these patients have relapsed after 5 years follow-up indicating that a noncisplatin containing regimen has the capacity to achieve durable remissions in this patient population. An evaluation of cisplatin containing salvage chemotherapy yielded a complete response rate of 31% among 32 treated patients equivalent to the study and emphasizing the need to reconsider the role of cisplatin in truly refractory patients.