Chemotherapy for good-risk germ cell tumors: current concepts and controversies

Through a series of well-designed randomized clinical trials, the treatment of patients with cisplatin-based chemotherapy has evolved such that approximately 90% of patients who have good-risk metastatic germ cell tumor (GCT) will be cured of their disease. At present, first-line chemotherapy for patients who have good-risk metastatic GCT is three cycles of bleomycin/etoposide/cisplatin. An alternative to this is four cycles of etoposide/cisplatin. This article examines the progress that has been made in the development of chemotherapy for good-risk metastatic GCT and raises questions for further consideration and investigation.