New chemotherapeutic approaches in testicular tumors

Abstract

Testicular cancer is the most common malignancy that develops in men between the ages of 20 and 40 years. Most testicular tumors are of germ cell origin and they are more sensitive to chemotherapy. After orchidectomy, while adjuvant radiotherapy, surveillance or adjuvant chemotherapy are recommended for early stage testicular seminomatous patients, surveillance; for early stage non-seminomatous patients, adjuvant chemotherapy, or retroperitoneal lymph-node dissection are proposed. In advanced germ cell tumors, conventional chemotherapy can cure up to 80% of patients. The combination of cisplatin, bleomycin, and etoposide has become the gold standard in this disease. Some patients with recurrent disease are candidates for salvage treatment. Recently, some studies have been reported that new potent anticancer agents, such as paclitaxel, gemcitabine, oxaliplatin, and irinotecan, can cause high complete response rates in germ cell tumors. In addition, the number of studies of targeted therapies has been increasing in these patients. In this review, we discussed the management of germ cell tumors, including conventional treatments, high dose chemotherapy, and new therapeutic agents.