Oncology Research and Treatment最新文献

{"title":"A Real-World Evaluation of Brain Imaging in Patients with Advanced Non-Small Cell Lung Cancer: Insights from a German Claims Data Analysis.","authors":"Akin Atmaca, Christian Grohé, Moritz Klinghardt, Nils Kossack, Marc Pignot, Roxana Schuh","doi":"10.1159/000547215","DOIUrl":"10.1159/000547215","url":null,"abstract":"<p><strong>Introduction: </strong>Brain metastases are a common risk in non-small cell lung cancer (NSCLC) patients. Generally, brain metastases are associated with reduced survival rates, and brain imaging is recommended during tumour staging. Here, we assess the incidence and survival among patients with non-curative advanced NSCLC (aNSCLC) with brain metastases, as well as the use and timing of brain imaging based on German claims data.</p><p><strong>Methods: </strong>Our study was based on claims data from about 4.5 million patients in Germany who are insured via statutory health insurance. 28,578 lung cancer patients were identified via ICD-10 code C34 during the study period from 2015 to 2021. Among them, patients with aNSCLC were determined using specific ICD-10 codes in combination with NSCLC disease- and stage-specific treatments. Brain metastases were identified via ICD-10 codes, while brain imaging was detected via OPS (operation and procedure classification system) and EBM (German Uniform Assessment Standard) codes.</p><p><strong>Results: </strong>The study population comprised 8,111 patients with aNSCLC, of which 7,010 patients (86.4%) had metastatic NSCLC (mNSCLC) and 1,101 patients (13.6%) had locally advanced NSCLC not amenable to curative-intended local therapy. The median overall survival (OS) of the entire study population was 9.2 months (95% CI: 8.9-9.6 months), of which 20.4% presented with brain metastases at initial diagnosis. Patients with brain metastases at diagnosis had a median OS of 6.1 months (5.7-6.6 months), as opposed to patients without brain metastases at diagnosis with a median OS of 9.5 months (9.0-9.9 months). Of the whole study population, 5,394 patients (66.5%) had received brain imaging at initial NSCLC diagnosis. Brain imaging was more common among patients with mNSCLC compared to those with locally advanced NSCLC (69.2% vs. 49.5%). The diagnostic setting (inpatient vs. outpatient, rural vs. urban location) had no apparent impact on the usage of brain imaging.</p><p><strong>Conclusion: </strong>Our study provides valuable insights into the routine practice of brain imaging in NSCLC patients in Germany. Our findings align with published evidence regarding incidence rates and mortality, again emphasising the prognostic relevance of brain metastases. Therefore, brain imaging at diagnosis should be used more commonly to detect brain metastases early on, which appeared insufficiently used in routine practice.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onkopedia: What's New? Systemic Tumor Treatment in Pregnancy.","authors":"Georg Maschmeyer, Tanja Fehm, Sibylle Loibl, Ralf Dittrich, Inken Hilgendorf","doi":"10.1159/000547137","DOIUrl":"10.1159/000547137","url":null,"abstract":"<p><strong>Background: </strong>An evidence-based clinical practice guideline for systemic cancer treatment in pregnant women is lacking.</p><p><strong>Summary: </strong>The German, Austrian, and Swiss Societies for Hematology and Medical Oncology have provided an updated guideline on systemic cancer treatment in pregnancy.</p><p><strong>Key messages: </strong>The gestational age and a multidisciplinary team are essential for treatment planning. A risk-benefit analysis is mandatory. Ultrasound and magnetic resonance imaging are preferred for diagnostic imaging during pregnancy. In the first trimester, there is an increased risk of malformations and miscarriages following systemic tumor therapy; therefore, such therapy is generally discouraged during this period. Systemic tumor therapy in the second and third trimester can result in outcomes comparable to a normal course of pregnancy and development. In cases of premature delivery, potential risks for the newborn should be considered. Systemically administered tumor therapeutics are dosed according to current standards. The use of certain medications, such as tyrosine kinase inhibitors, VEGF antibodies, anti-hormonal substances, and immune checkpoint inhibitors, is generally advised against during pregnancy. Supportive therapy agents can predominantly be used in the second and third trimesters without significant late effects for the newborn. The goal is a spontaneous delivery as for non-cancer patients; early induction of labor and Caesarian section (except for patients with cervical cancer) are discouraged. A minimum interval of 3 weeks between myelosuppressive systemic therapy and delivery is recommended to reduce potential complications. As a rule, normal early and late child development can be expected if established treatment recommendations are followed. Patient data should be entered into established registries.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-15"},"PeriodicalIF":1.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144554068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Path to Clinical Implementation of <italic>DPYD</italic> Pharmacogenetic Testing: Long-Term Experience from an External Quality Assessment Provider and a University Testing Center.","authors":"Maren Hedtke, Volker Ast, Johannes Leidheiser, Anja Kessler, Michael Neumaier, Ralf-Dieter Hofheinz, Verena Haselmann","doi":"10.1159/000546912","DOIUrl":"10.1159/000546912","url":null,"abstract":"<p><strong>Introduction: </strong>Pharmacogenetics (PGx) plays a crucial role in precision medicine by identifying genetic variations that influence drug metabolism. For example, variants in dihydropyrimidine dehydrogenase (DPYD) have an impact on DPD enzyme activity and consequently on the metabolization of 5-fluorouracil, which can lead to severe adverse drug reactions. Therefore, pre-emptive DPYD genotyping was endorsed by the European Medicines Agency (EMA) in mid-2020 and subsequently included in national guidelines. In this study, we evaluated the impact of these guidelines on the request behavior for DPYD genotyping at a German university hospital in Mannheim (UMM) and on participation in external quality assessment (EQA) schemes in the European setting.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 386 DPYD genetic tests performed as part of standard care at the University Medical Center Mannheim from 2015 to 2021. Patient data, including demographics, diagnosis, and treatment, were obtained from electronic health records. Additionally, EQA data from the Reference Institute for Bioanalytics from 2015 to 2023 were analyzed to evaluate the adoption of DPYD testing across European laboratories.</p><p><strong>Results: </strong>The study observed a significant increase in DPYD genotyping requests at UMM following the EMA recommendation in 2020, with an up to 29-fold increase compared to previous years. Furthermore, a shift from post-treatment to pre-treatment genotyping was observed. DPYD variants were detected in 6.5% of cases, with DPYD HapB3 being the most frequent. EQA data from 23,114 genotypes demonstrated a growing participation in proficiency testing across Europe, indicating broader clinical adoption, and confirmed the impact on testing requirements in national guidelines on integration into clinical workflows.</p><p><strong>Conclusion: </strong>The integration of DPYD testing into national guidelines has significantly increased its clinical adoption, enhancing patient safety in oncology. However, standardization challenges remain. Further harmonization of guidelines and expansion of PGx testing may further optimize chemotherapy safety in the future.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Stress in Breast Cancer Patients during the Course of a Pandemic Disease: Before and after the Availability of Vaccines.","authors":"Tanja Schlaiß, Mariana Dimova Vassilenko, Theresa Kimmel, Joachim Diessner, Achim Wöckel, Rhiannon McNeill, Sarah Kittel-Schneider, Ulrike Kämmerer, Catharina Bartmann","doi":"10.1159/000546837","DOIUrl":"10.1159/000546837","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic led to restrictions in public life and significantly impaired treatment processes for oncological treatments. In this trial, we compared breast cancer (BC) patients' psychological stress before and after the availability of vaccines against COVID-19.</p><p><strong>Methods: </strong>Patients that received preoperative, postoperative, or palliative treatment for their BC diagnosis during the COVID-19 pandemic between 2020 and 2022 were included. Cohort 1 comprised patients prior to the availability of vaccines and Cohort 2 comprised patients from 2021 when vaccines against COVID-19 were available. We evaluated differences in mental state, influencing factors on quality of life (QoL) and factors causing distress during their BC treatments by several questionnaires.</p><p><strong>Results: </strong>When comparing 82 BC patients (Cohort 1) with 91 patients (Cohort 2), we found quite similar psychosocial parameters and secondary diagnoses. Eighty-five patients (93.41%) in Cohort 2 had been vaccinated. The cohorts did not differ regarding their concern toward the pandemic. We found that stress caused by insecurity (19.00 [11.00-26.00] in Cohort 1 vs. 16.00 [10.00-21.00] in Cohort 2 [p = 0.050]) and stress by loss (11.00 [9.00-16.00] in Cohort 1 vs. 10.00 [7.00-13.00] in Cohort 2 [p = 0.047]) decreased in Cohort 2, while all other parameters of distress did not show differences. Patients in Cohort 2 felt moderate burden due to restriction of accompanying persons and visits during hospitalization without corresponding changes to the QoL. In contrast, their own vaccination and the vaccination of their relatives showed positive impact on their QoL. Vaccination appeared to only minimally affect everyday behavior.</p><p><strong>Conclusion: </strong>This trial shows positive psychological vaccination effects with only a limited influence on the distress of BC patients.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-14"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Disaggregated Analysis of Pneumonia in Patients with High-Risk Neutropenia.","authors":"Alva Seltmann, Karin Mayer, Corinna Hahn-Ast, Annamaria Brioli, Maria Madeleine Rüthrich, Peter Brossart, Andreas Hochhaus, Marie von Lilienfeld-Toal","doi":"10.1159/000546911","DOIUrl":"10.1159/000546911","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumonia is a common and serious complication during high-risk neutropenia in patients with cancer. Even though sex differences were described in patients with infectious diseases or cancer in general, sex-specific analyses for pneumonia are lacking. This exploratory study aimed to compare epidemiology and outcome of pneumonia between men and women in this high-risk cohort.</p><p><strong>Methods: </strong>Patient data were harmonized from four primary databases collected by our research group at two tertiary care centers in Germany. High-risk neutropenia was either defined by duration of neutropenia or assumed for autologous or allogeneic hematopoietic stem cell transplantation. All patients who developed pneumonia associated with febrile neutropenia were stratified by sex, and their characteristics during the first observed pneumonia case were compared. Additionally, all identified causative pathogens were stratified by sex and described.</p><p><strong>Results: </strong>In total, 906 patients contributed 1,511 cases of high-risk neutropenia. Pneumonia occurred in 110/689 (16.0%) of cases in women and 132/822 (16.1%) of cases in men. Patient characteristics such as age, underlying disease, and risk factors like duration of neutropenia did not show significant differences. Intensive care unit treatment was needed by 15/97 (15.5%) women and 22/104 (21.2%) men, and the inhospital mortality was 5/98 (5.1%) in women and 12/113 (10.6%) in men, but this result did not reach statistical significance. Seventy-three causative pathogens were identified. Among them, Gram-positive pathogens were identified in three times as often in women (13/36 [36.1%]) than in men (5/37 [13.5%]; p < 0.001, q = 0.002). In contrast, fungi were identified twice as often in men (13/37 [35.1%]) than in women (7/36 [19.4%]; p < 0.001, q = 0.002).</p><p><strong>Conclusion: </strong>Our exploratory study suggests that while pneumonia rates are similar in women and men, pathogen patterns differ and outcomes may be different. These findings should be verified prospectively and in larger cohorts.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Antithrombotic Treatment in Patients with Immune Thrombocytopenia.","authors":"Rosa Sonja Alesci, Oliver Meyer, Hanno Riess, Axel Matzdorff","doi":"10.1159/000546860","DOIUrl":"10.1159/000546860","url":null,"abstract":"<p><strong>Introduction: </strong>The number of patients requiring anticoagulation, e.g., for cardiovascular diseases, is increasing, even in patients with immune thrombocytopenia (ITP). However, detailed guidelines and studies are lacking. In clinical trials in ITP, patients taking anticoagulants are usually excluded and patients with thrombocytopenia are often excluded from anticoagulation studies. Our main goal was to highlight factors that influence anticoagulation decision-making in the clinical routine.</p><p><strong>Methods: </strong>We conducted a survey to explore the preferred management of anticoagulation therapy in patients with ITP. It presented common patient scenarios and elicited factors influencing decisions regarding whether to initiate anticoagulation therapy.</p><p><strong>Results: </strong>We surveyed 235 colleagues in Germany, Austria, and Switzerland. A total of 210 respondents specialized in hematology; 13 had advanced training in hemostaseology. About half (110/210; 55%) of participants treat 5-10 patients with ITP per month. The recommended platelet thresholds for antithrombotic therapy were similar among patients with ITP. Most participants recommended a minimum platelet count of 50 × 109/L for anticoagulation therapy in most scenarios. However, there was great variability in individual practice patterns among the respondents. The psychosocial status of patients was important for decision-making.</p><p><strong>Conclusion: </strong>Deciding on anticoagulation therapy in patients with ITP remains challenging. Our survey illustrated the diverse perspectives of medical professionals on managing anticoagulation therapy in ITP. A platelet count of >50 × 109/L was considered safe. In patients with lower platelet counts, other influencing factors such as bleeding tendency, comorbidities, and psychosocial status become relevant. Our findings emphasize the importance of balanced clinical judgment, the need for evidence-based guidelines, and open discussions with patients to optimize treatment strategies.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Composition and Inflammation as Emerging Sex-Specific Prognostic Factors in Patients with Advanced Cutaneous Melanoma Undergoing Immune Checkpoint-Inhibition Therapy: A Prospective Pilot Study.","authors":"Jana Knuever, Oana-Diana Persa, Lukas Gerecht, Max Schlaak, Sebastian Theurich","doi":"10.1159/000546797","DOIUrl":"10.1159/000546797","url":null,"abstract":"<p><strong>Introduction: </strong>The distribution of muscle and adipose tissues masses physiologically follow sex-specific patterns. On the other hand, the clinical and biological consequences of pathologic body composition, i.e., sarcopenia or obesity, also depend on tissue distribution patterns. Although obesity-associated inflammation has been correlated with survival benefits of cancer patients undergoing immune checkpoint inhibition (ICI) therapy, detailed and sex-specific body composition analyses are widely missing. Here, we prospectively analyzed body composition and serum parameters of inflammation and protein metabolism in patients with advanced melanoma before and 3 months after initiation of ICI therapy.</p><p><strong>Methods: </strong>Between 2016 and 2018, consecutive patients with advanced cutaneous melanoma were recruited into the study at our cancer center (Skin Cancer Center, CIO, University Hospital Cologne, Germany). Blood samples and body composition based on bioelectrical impedance analysis (BIA) were assessed before ICI therapy initiation (T1) and after 3 months (T2). Correlation of blood parameters with body composition as well as progression-free (PFS) and overall survival (OS) was analyzed in sex-specific subgroups.</p><p><strong>Results: </strong>From a total of 54 patients, 25 were women and 29 were men. In women, a high muscle mass at T1 was the strongest marker for longer PFS (HR 0.84; 95% CI: 0.74-0.98; p = 0.024), while in men (n = 29), high phase angle values at T1 correlated with significantly longer PFS (HR 0.48; 95% CI: 0.26-0.90; p = 0.023). Regarding OS, muscle mass status at T1 remained the strongest predictor for longer survival in women (HR 0.85; 95% CI: 0.72-0.99; p = 0.033), while in men, increased leukocyte blood counts at T1 were associated with the poorest OS (HR 1.36; 95% CI: 1.14-1.62; p = 0.001). Inflammation and the immuno-nutritional score mGPS correlated with body composition parameters in a sex-specific manner. However, we did not observe an impact of dynamic changes between T1 and T2 in all analyzed parameters.</p><p><strong>Conclusion: </strong>Our data suggest that BIA-derived markers are associated with the prognosis of melanoma patients undergoing ICI therapy in a sex-specific manner. Selected body composition parameters correlate differently with blood markers of inflammation and protein metabolism in men and women. If validated in larger trials, these assessments might improve individualized supportive care and clinical risk stratification.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albert Schweitzer, Chronic Myeloid Leukemia, and War.","authors":"Enrico Schalk","doi":"10.1159/000546408","DOIUrl":"10.1159/000546408","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-3"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12252140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Advanced Renal Cell Carcinoma.","authors":"Xin-Wen Zhang, Dirk Jäger, Stefanie Zschäbitz","doi":"10.1159/000546879","DOIUrl":"10.1159/000546879","url":null,"abstract":"<p><strong>Background: </strong>Management of advanced renal cell carcinoma (RCC) has evolved significantly in the last years. Systemic treatment of clear cell RCC, the predominant subtype, is performed with immune checkpoint inhibitors (ICIs), anti-VEGF tyrosine kinase inhibitor (TKI), HIF2α inhibitors and mTOR inhibitors.</p><p><strong>Summary: </strong>The application of ICI in early disease has raised new challenges regarding subsequent therapy strategies and management of new toxicities of immunotherapy-based combination therapies. Systemic treatment for non-clear cell RCC is challenging due to the lack of robust clinical evidence for effective treatment regimens. Recent phase-2 data also indicate a benefit of ICI-combination therapies for non-clear cell RCC. For oligometastatic or oligoprogressive diseases, local therapy with cytoreductive nephrectomy, metastasectomy or stereotactic radiation can be considered. This review provides a comprehensive overview of current treatment strategies for advanced RCC, including systemic therapies for both clear cell and non-clear cell subtypes, management of treatment-associated toxicities, and the role of local therapies.</p><p><strong>Key messages: </strong>Combination therapy for clear cell RCC is standard in first-line therapy and published data also support its use in non-clear cell carcinoma. Local therapies can be considered in selected patients. In subsequent treatment lines TKIs, mTOR inhibitors and the HIF2α inhibitor belzutifan are used.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Advanced Germ Cell Tumours.","authors":"Fabrizio Di Costanzo, Pasquale Rescigno, Christoph Seidel, Thomas Morrall, Pedro Oliveira, Marcus Hentrich, Christoph Oing","doi":"10.1159/000546798","DOIUrl":"10.1159/000546798","url":null,"abstract":"<p><strong>Background: </strong>Male germ cell tumours are an exemplar of a highly curably malignancy and represent the most frequent solid malignancy among men under the age of 40. The majority of cases are detected while the tumour is confined to the testicle where cure rates exceed 99%. Even in cases of metastatic disease expansion, cure rates remain extraordinary compared to other malignancies, owing to the unique sensitivity of most germ cell tumour components to cisplatin-based chemotherapy.</p><p><strong>Summary: </strong>The treatment of metastatic germ cell tumours is adapted to (i) primary histology (seminoma versus non-seminoma or mixed germ cell tumour), (ii) disease spread (clinical stage IIA/B versus IIC/III), and (iii) clinical risk according to the International Germ Cell Cancer Collaborative Group classification. Across all metastatic stages, the combination of bleomycin, etoposide, and cisplatin is most commonly used. In non-seminomas, post-chemotherapy residual mass resection is the second cornerstone of treatment. Among patients who relapse after first-line chemotherapy, platinum-based conventional dose or high-dose chemotherapy regimens can still achieve cure in 50% of patients. Outcomes for patients with multiple relapses, however, remain dissatisfactory and novel treatment approaches are urgently needed. High cure rates demand cautious consideration of possible long-term side effects. Novel strategies are being explored to mitigate the risk of long-term morbidity without lowering the outstanding cure rates.</p><p><strong>Key messages: </strong>(i) Advanced germ cell tumours are highly curable with cisplatin-based combination chemotherapy and often surgical post-chemotherapy residual mass resection. (ii) Novel de-escalation strategies and survivorship programs aim to mitigate the risk of long-term treatment side effects. A lack of effective molecularly targeted treatment approaches pinpoints the need for novel treatments for multiply relapsed, platinum-resistant disease.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}