Journal article
Consensus Recommendations from the Spanish Germ Cell Cancer Group on the Use of High-dose Chemotherapy in Germ Cell Cancer.
- González-Billalabeitia E University Hospital Morales Meseguer, UCAM, Murcia, Spain. Electronic address: enrique.gonzalezbilla@gmail.com.
- Sepúlveda JM Hospital 12 de Octubre, Madrid, Spain.
- Maroto P Hospital de la Santa Creu i San Pau, Barcelona, Spain.
- Aparicio J University Hospital La Fe, Valencia, Spain.
- Arranz JA Gregorio Marañón General University Hospital, Madrid, Spain.
- Esteban E Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
- Gironés R Medical Oncology Unit, Hospital Lluís Alcanyís, Xàtiva, Spain.
- López-Brea M Marqués de Valdecilla University Hospital, Santander, Spain.
- Mendez-Vidal MJ Reina Sofía University Hospital, Córdoba, Spain.
- Pinto A La Paz University Hospital, Madrid, Spain.
- Sastre J San Carlos University Hospital, Madrid, Spain.
- de Prado DS Hospital Clinico Universitario, Valladolid, Spain.
- Terrasa J Hospital Son Espases, Palma de Mallorca, Spain.
- Vázquez S Lucus Augusti University Hospital, Lugo, Spain.
- Powles T Barts Health NHS Trust - St Bartholomew's, London, UK.
- Beyer J University Hospital Zurich, Zurich, Switzerland.
- Castellano D Hospital 12 de Octubre, Madrid, Spain.
- Del Muro XG Institut Català d'Oncologia L'Hospitalet, Barcelona, Spain.
- 2017-07-30
Published in:
- European urology focus. - 2017
Autologous bone marrow transplant
Germ cell cancer
High-dose chemotherapy
Salvage therapy
Testicular
Antineoplastic Combined Chemotherapy Protocols
Consensus
Humans
Male
Neoplasms, Germ Cell and Embryonal
Salvage Therapy
Spain
Testicular Neoplasms
English
BACKGROUND
High-dose chemotherapy (HDCT) has been studied in several clinical scenarios in advanced germ cell cancer (GCC).
OBJECTIVE
To establish a clinical practice guideline for HDCT use in the treatment of GCC patients.
DESIGN, SETTING, AND PARTICIPANTS
An expert panel reviewed information available from the literature. The panel addressed relevant issues concerning and related to HDCT. The guideline was externally reviewed by two international experts.
RESULTS AND LIMITATIONS
The efficacy of HDCT has been demonstrated in selected GCC patients. The most conclusive evidence comes from retrospective analyses that need to be interpreted with caution. HDCT can cure a significant proportion of heavily treated GCC patients. When indicated, sequential HDCT with regimens containing carboplatin and etoposide, as well as peripheral stem-cell support, is recommended. There is no conclusive evidence to recommend HDCT as first-line therapy. According to a multinational retrospective pooled analysis, HDCT might be superior to conventional CT as first salvage treatment in selected patients. There is an urgent need for prospective clinical trials addressing the value of HDCT in GCC patients who experience failure on first-line cisplatin-based CT. In patients who progress on conventional-dose salvage CT, HDCT should be considered. Treatment of these patients at experienced centers is strongly recommended.
CONCLUSIONS
It has been demonstrated that HDCT cures selected GCC patients who experience disease progression on conventional rescue regimens. The panel recommends the inclusion of GCC patients in randomized clinical trials including HDCT.
PATIENT SUMMARY
This consensus establishes clinical practice guidelines for the use and study of high-dose chemotherapy in patients with germ cell cancer.
High-dose chemotherapy (HDCT) has been studied in several clinical scenarios in advanced germ cell cancer (GCC).
OBJECTIVE
To establish a clinical practice guideline for HDCT use in the treatment of GCC patients.
DESIGN, SETTING, AND PARTICIPANTS
An expert panel reviewed information available from the literature. The panel addressed relevant issues concerning and related to HDCT. The guideline was externally reviewed by two international experts.
RESULTS AND LIMITATIONS
The efficacy of HDCT has been demonstrated in selected GCC patients. The most conclusive evidence comes from retrospective analyses that need to be interpreted with caution. HDCT can cure a significant proportion of heavily treated GCC patients. When indicated, sequential HDCT with regimens containing carboplatin and etoposide, as well as peripheral stem-cell support, is recommended. There is no conclusive evidence to recommend HDCT as first-line therapy. According to a multinational retrospective pooled analysis, HDCT might be superior to conventional CT as first salvage treatment in selected patients. There is an urgent need for prospective clinical trials addressing the value of HDCT in GCC patients who experience failure on first-line cisplatin-based CT. In patients who progress on conventional-dose salvage CT, HDCT should be considered. Treatment of these patients at experienced centers is strongly recommended.
CONCLUSIONS
It has been demonstrated that HDCT cures selected GCC patients who experience disease progression on conventional rescue regimens. The panel recommends the inclusion of GCC patients in randomized clinical trials including HDCT.
PATIENT SUMMARY
This consensus establishes clinical practice guidelines for the use and study of high-dose chemotherapy in patients with germ cell cancer.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.euf.2016.07.002
- PMID 28753776
- Persistent URL
- https://sonar.ch/global/documents/47644
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