Pharmacotherapy of relapsed metastatic testicular cancer

BACKGROUND: Patients with metastatic testicular cancer exhibit an excellent prognosis. However, the outcome for patients with relapse after cisplatin-based chemotherapy remains unsatisfactory. Several larger studies have been recently published. OBJECTIVE: To review the treatment of patients with testicular cancer after failure of first-line chemotherapy. METHODS: A literature search was performed for studies investigating therapies for relapsed testicular cancer. RESULTS/CONCLUSIONS: The prognosis of patients relapsing after first-line cisplatin-based chemotherapy has improved with multimodality therapy, including conventional and high-dose chemotherapy, surgery and radiation. Prognostic factors are increasingly used to guide treatment intensity. High-dose chemotherapy has become an accepted treatment option, in particular in patients with poor risk factors at relapse. The outcome of patients with multiply relapsed or cisplatin-refractory disease remains particularly poor. Treatment of relapsed patients requires a close cooperation of medical oncologists, urologists, surgeons and radiation oncologists with extensive experience in this disease.