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Targeted and Selective Treatment of Pluripotent Stem Cell-derived Teratomas Using External Beam Radiation in a Small-animal Model
Published on: February 17, 2019
Recent developments and outstanding challenges in germ cell tumors
Ahmed Bilal Khalid1, Tareq Salous
1Department of Internal Medicine, Division of Hematology/Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Purpose Of Review:
Remaining challenges in management of patients with germ cell tumors (GCTs) include selecting the optimal treatment modality in patients with early metastatic disease, biomarker development and developing newer treatments in patients with refractory disease. This review aims to highlight recent developments in these domains.
Recent Findings:
For patients with testicular seminoma with low-volume retroperitoneal lymphadenopathy, retroperitoneal lymph node dissection is a viable treatment option. Novel biomarkers showing promise in patients with GCTs include circulating tumor DNA and microRNA 371; with further validation from larger prospective studies, these may be useful in clinical decision making in patients with GCTs. Claudin 6's ubiquitous expression in testicular GCTs has enabled the development of several ongoing clinical trials targeting it and these therapies may be promising in treating patients with refractory GCTs.
Summary:
Management of patients with GCT requires a multidisciplinary approach and patients with advanced disease being considered for surgery or those with refractory disease should be referred to a high-volume treatment center. Outcomes in refractory GCT remain poor, but several novel treatment options and approaches are being explored in clinical trials to improve cure rates in this patient population.
Insights
Optimizing treatment for germ cell tumors (GCTs) involves selecting therapies for early metastatic disease and developing new treatments for refractory GCTs. Promising biomarkers and targeted therapies are emerging for improved patient outcomes.
Area of Science:
- Oncology
- Genitourinary Cancers
- Cancer Biomarkers
Background:
- Germ cell tumors (GCTs) present ongoing management challenges, particularly in early metastatic and refractory disease.
- Optimal treatment selection and biomarker development are critical areas for improving GCT patient outcomes.
Purpose of the Study:
- To review recent advancements in the management of germ cell tumors (GCTs).
- To highlight progress in treatment modalities for early metastatic and refractory GCTs.
- To discuss novel biomarker development for GCT patient care.
Main Methods:
- Literature review of recent developments in GCT management.
- Analysis of emerging treatment strategies and biomarkers.
- Synthesis of findings related to surgical options, biomarkers, and novel therapies.
Main Results:
- Retroperitoneal lymph node dissection is a viable option for seminoma with low-volume retroperitoneal lymphadenopathy.
- Circulating tumor DNA and microRNA 371 show promise as biomarkers for GCTs.
- Claudin 6 targeted therapies are under investigation for refractory GCTs.
Conclusions:
- Multidisciplinary care is essential for GCT management.
- Referral to high-volume centers is recommended for advanced or refractory GCT cases.
- Novel therapies in clinical trials offer hope for improving cure rates in refractory GCTs.
