David J Vaughn MD

Division of Hematology/Oncology, Abramson Cancer Center of the University of Pennsylvania, 16 Penn Tower, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA

In 2007, an estimated 7920 American men will be diagnosed with germ cell tumor (GCT), with an estimated 380 deaths [1]. The number of patients who have GCT who die each year of this disease has markedly decreased since the early 1970s because of the development of effective systemic chemotherapy and the successful incorporation of postchemotherapy surgery into treatment. Through a series of well-designed randomized clinical trials, the treatment of patients with cis-platin-based chemotherapy has evolved such that approximately 90% of patients who have good-risk metastatic GCT will be cured of their disease. This finding represents a landmark achievement in oncology. At present, first-line chemotherapy for patients who have good-risk metastatic GCT is three cycles of bleomycin/etoposide/cisplatin (BEP). An alternative to this is four cycles of eto-poside/cisplatin (EP). These regimens are depicted in Box 1. This article examines the progress that has been made in the development of chemotherapy for good-risk metastatic GCT and raises questions for further consideration and investigation.

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