High-Dose Chemotherapy and Stem-Cell Rescue for Metastatic Germ-Cell Tumors

This article summarizes the experience of a single institution in treating patients with metastatic testicular tumors that did not respond to cisplatin-based chemotherapy. High-dose chemotherapy with hematopoietic stem-cell rescue was potentially curative in such cases. In patients with metastatic testicular tumors that did not respond to cisplatin-based chemotherapy, high-dose chemotherapy with hematopoietic stem-cell rescue was potentially curative. Germ-cell tumors are curable even in the presence of metastatic disease. 1 – 3 An international collaboration has established that metastatic germ-cell tumors can be classified into good-, intermediate-, and poor-risk disease, with corresponding cure rates of 90 to 95%, 75%, and 40 to 50%, respectively. 4 Hereinafter, we refer to these categories as low-, intermediate-, and high-risk disease, respectively. Patients with tumors that relapse or with tumors that progress despite initial chemotherapy are candidates for salvage therapy. The few patients with anatomically confined disease are amenable to surgical extirpation. 5 For most patients, however, the options include salvage chemotherapy with cisplatin plus ifosfamide . . .