7. Malignant germ cell tumors

  1. Ross Pinkerton MB, BCh, BaO, MD Executive Director, Division of Oncology2,
  2. Ananth Shankar MD, FRCPCH Consultant in Paediatric and Adolescent Oncology3 and
  3. Katherine K. Matthay BA, MD Mildred V. Strouss Professor of Translational Oncology, Director, Pediatric Hematology-Oncology4
  1. Ross Pinkerton

Published Online: 8 MAY 2013

DOI: 10.1002/9781118625309.ch7

Evidence-Based Pediatric Oncology

Evidence-Based Pediatric Oncology

How to Cite

Pinkerton, R. (2013) Malignant germ cell tumors, in Evidence-Based Pediatric Oncology (eds R. Pinkerton, A. Shankar and K. K. Matthay), John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118625309.ch7

Editor Information

  1. 2

    Royal Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia

  2. 3

    University College London Hospitals NHS Foundation Trust London, UK

  3. 4

    Department of Pediatrics, UCSF School of Medicine and, UCSF Benioff Children's Hospital, San Francisco, CA, USA

Author Information

  1. Royal Children's Hospital, Brisbane, QLD, Australia

Publication History

  1. Published Online: 8 MAY 2013
  2. Published Print: 20 MAY 2013

ISBN Information

Print ISBN: 9780470659649

Online ISBN: 9781118625309

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Keywords:

  • children;
  • cisplatin-based treatment regimens;
  • high-dose chemotherapy;
  • malignant germ cell tumors (MGCT);
  • randomized trials

Summary

The introduction of cisplatin-based treatment regimens in pediatric malignant germ cell tumors (MGCT), based on effectiveness in adults with testicular tumors, had a dramatic effect on outcome, being clearly superior to previous regimens including vincristine, actinomycin D and cyclophosphamide (VAC). Few children's cancers illustrate better the difficulties in design and execution of randomized trials in rare cancers. High-dose chemotherapy with stem cell rescue has been used in relapse protocols following practice in adults where it has been associated with encouraging outcomes in platinum-refractory patients. Whilst the number of children with relapsed MGCT is relatively small, second-line and third-line therapy could be the subject of combined international studies. The COG, for example, recently completed a study to evaluate the use of a paclitaxel, ifosfamide, and carboplatin combination in recurrent or resistant MGCT.