High dose chemotherapy and stem cell support for poor risk and recurrent nonseminomatous germ cell cancer: initial...

Approximately 20% of patients with germ cell tumours do not respond fully to standard therapy, or relapse after treatment. The prognosis of these patients is poor with conventional chemotherapy. Preliminary data suggest that they may have a higher durable response rate with high dose chemotherapy and peripheral blood stem cell support.

To treat a group of testicular cancer patients, either with relapsed disease or with poor prognostic features initially, with high dose chemotherapy and stem cell support, and evaluate their outcome.

Five patients with testicular cancer were treated with high dose chemotherapy and stem cell support. Of these, four underwent this treatment as salvage therapy and one patient with poor prognostic features was treated as primary treatment.

At an average follow-up of 18 months, four patients remain free of disease while one patient has developed relapse.

This report provides further support for high dose chemotherapy in this setting although randomised, controlled trials are essential to clarify its use.