Key Points in the USC Approach to Salvage Chemotherapy for Germ Cell Tumors
- IPFSG very-low-risk and low-risk patients, such as those with seminoma and low levels of tumor markers, may be effectively salvaged with standard-dose chemotherapy, typically TIP.
- HDC-ASCR (we use TI-CE) should be offered to very high-risk and high-risk relapsed patients with germ cell tumors, as well as select intermediate-risk patients at first relapse, and all patients beyond first relapse.
- Chemotherapy regimens such as intensified GOT may offer remissions even after failure of transplant.
GOT = gemcitabine, oxaliplatin, paclitaxel; HDC-ASCR = high-dose chemotherapy with autologous stem cell rescue; IPFSG = International Prognostic Factors Study Group; TI-CE = paclitaxel, ifosfamide induction followed by high-dose carboplatin, etoposide; TIP = paclitaxel, ifosfamide, cisplatin; USC = University of Southern California.