Journal article
Role of one, two and three doses of high-dose chemotherapy with autologous transplantation in the treatment of high-risk or relapsed testicular cancer: a systematic review
Bone marrow transplantation (Basingstoke), Vol.53(10), pp.1242-1254
10/2018
DOI: 10.1038/s41409-018-0188-3
PMID: 29703969
Abstract
Approximately 20-30% of patients with metastatic germ cell cancers (GCCs) can develop relapsed or refractory (RR) disease, about 40-50% of patients who relapse after salvage chemotherapy may reach long-term remission. The goal of this review was to identify patients who appear to benefit from high-dose chemotherapy (HDCT) and autologous stem cell transplant (ASCT). To access this, we performed a systematic medical literature review to evaluate the effectiveness of HDCT in the frontline setting, as well as in patients with RR testicular cancer. We searched databases for interventional clinical studies and identified 5883 studies. We selected 49 studies for inclusion, which included a total of 5985 patients. Seventeen studies reported results of newly diagnosed poor-risk GCC patients and 32 studies reported results of RR patients. For newly diagnosed patients with poor prognostic predictors, a risk adjusted strategy using unfavorable tumor marker decline with initial standard chemotherapy regimen and upfront HDCT demonstrated improved outcomes. Our data suggest a minimum of two HDCT cycles with ASCT should be standard of care for patients with RR GCC. Failure of HDCT results in a poor prognosis with only 10% of patients achieving lasting remission with salvage therapy.
Details
- Title: Subtitle
- Role of one, two and three doses of high-dose chemotherapy with autologous transplantation in the treatment of high-risk or relapsed testicular cancer: a systematic review
- Creators
- Irbaz Bin Riaz - Mayo Clinic Rochester, MNMuhammad Umar - Icahn School of Medicine at Mount SinaiUmar Zahid - University of ArizonaMuhammad Husnain - University of MiamiAhmad Iftikhar - University of ArizonaAli McBride - University of ArizonaJawad Bilal - University of ArizonaAsad Javed - Aga Khan UniversitySara Akbar - Aga Khan UniversityParminder Singh - Mayo Clinic in ArizonaZeeshan Ali - University of ArizonaQurat Ul Ain Riaz Sipra - University of ArizonaFarva Razia Gondal - University of ArizonaFrederick Ahman - University of ArizonaFaiz Anwer - University of Arizona
- Resource Type
- Journal article
- Publication Details
- Bone marrow transplantation (Basingstoke), Vol.53(10), pp.1242-1254
- DOI
- 10.1038/s41409-018-0188-3
- PMID
- 29703969
- NLM abbreviation
- Bone Marrow Transplant
- ISSN
- 0268-3369
- eISSN
- 1476-5365
- Grant note
- P30 CA023074 / NCI NIH HHS
- Language
- English
- Date published
- 10/2018
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984363152702771
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