The majority of metastatic germ cell tumors (GCTs) are cured with cisplatin-based chemotherapy, but 20ââ?¬â??30% of patients will\nrelapse after first-line chemotherapy and require additional salvage strategies. The two major salvage approaches in this scenario\nare high-dose chemotherapy (HDCT) with autologous stem cell transplant (ASCT) or conventional-dose chemotherapy (CDCT).\nBoth CDCT and HDCT have curative potential in the management of relapsed/refractory GCT. However, due to a lack of\nconclusive randomized trials, it remains unknown whether sequential HDCT or CDCT represents the optimal initial salvage\napproach, with practice varying between tertiary institutions. This represents the most pressing question remaining for defining\nGCT treatment standards and optimizing outcomes. The authors review prognostic factors in the initial salvage setting as well as\nthe major studies assessing the efficacy of CDCT, HDCT, or both, describing the strengths and weaknesses that formed the\nrationale behind the ongoing international phase III ââ?¬Å?TIGERââ?¬Â trial.
Loading....