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Author Notes:

Corresponding author: Thomas A. Olson, MD, Division Pediatric Hematology/Oncology, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, 2015 Uppergate Dr NE, Atlanta, GA 30322; e-mail: Thomas.Olson@choa.org.

Financial support: Thomas A. Olson

Administrative support: Thomas A. Olson, Carlos Rodriguez-Galindo, Mark D. Krailo

Provision of study materials or patients: Thomas A. Olson, Deborah F. Billmire

Manuscript writing: All authors

Final approval of manuscript: All authors

Please see original article for full disclosure of conflicts of interest

Subjects:

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • CHILDRENS ONCOLOGY GROUP
  • HIGH-DOSE CHEMOTHERAPY
  • INTENSIVE INDUCTION CHEMOTHERAPY
  • COUNCIL EUROPEAN ORGANIZATION
  • RANDOMIZED PHASE-III
  • STAGE-I
  • TESTICULAR CANCER
  • UNITED-KINGDOM
  • COMBINATION CHEMOTHERAPY
  • YOUNG-ADULTS

Pediatric and Adolescent Extracranial Germ Cell Tumors: The Road to Collaboration

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Journal Title:

Journal of Clinical Oncology

Volume:

Volume 33, Number 27

Publisher:

, Pages 3018-U119

Type of Work:

Article | Final Publisher PDF

Abstract:

During the past 35 years, survival rates for children with extracranial malignant germ cell tumors (GCTs) have increased significantly. Success has been achieved primarily through the application of platinum-based chemotherapy regimens; however, clinical challenges in GCTs remain. Excellent outcomes are not distributed uniformly across the heterogeneous distribution of age, histologic features, and primary tumor site. Despite good outcomes overall, the likelihood of a cure for certain sites and histologic conditions is less than 50%. In addition, there are considerable long-term treatment-related effects for survivors. Even modest cisplatin dosing can cause significant long-term morbidities. A particular challenge in designing new therapies for GCT is that a variety of specialists use different risk stratifications, staging systems, and treatment approaches for three distinct age groups (childhood, adolescence, and young adulthood). Traditionally, pediatric cancer patients younger than 15 years have been treated by pediatric oncologists in collaboration with their surgical specialty colleagues. Adolescents and young adults with GCTs often are treated by medical oncologists, urologists, or gynecologic oncologists. The therapeutic dilemma for all is how to best define disease risk so that therapy and toxicity can be appropriately reduced for some patients and intensified for others. Further clinical and biologic insights can only be achieved through collaborations that do not set limitations by age, sex, and primary tumor site. Therefore, international collaborations, spanning different cooperative groups and disciplines, have been developed to address these challenges.

Copyright information:

© 2015 by American Society of Clinical Oncology.

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