TY - JOUR
T1 - Pediatric and adolescent extracranial germ cell tumors
T2 - The road to collaboration
AU - Olson, Thomas A.
AU - Murray, Matthew J.
AU - Rodriguez-Galindo, Carlos
AU - Nicholson, James C.
AU - Billmire, Deborah F.
AU - Krailo, Mark D.
AU - Dang, Ha M.
AU - Amatruda, James F.
AU - Thornton, Claire M.
AU - Arul, G. Suren
AU - Stoneham, Sara J.
AU - Pashankar, Farzana
AU - Stark, Daniel
AU - Shaikh, Furqan
AU - Gershenson, David M.
AU - Covens, Allan
AU - Hurteau, Jean
AU - Stenning, Sally P.
AU - Feldman, Darren R.
AU - Grimison, Peter S.
AU - Huddart, Robert A.
AU - Sweeney, Christopher
AU - Powles, Thomas
AU - Lopes, Luiz Fernando
AU - Dos Santos Agular, Simone
AU - Chinnaswamy, Girish
AU - Khaleel, Sahar
AU - Abouelnaga, Sherif
AU - Hale, Juliet P.
AU - Frazier, A. Lindsay
N1 - Publisher Copyright:
© 2015 by American Society of Clinical Oncology.
PY - 2015/9/20
Y1 - 2015/9/20
N2 - 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.
AB - 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.
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U2 - 10.1200/JCO.2014.60.5337
DO - 10.1200/JCO.2014.60.5337
M3 - Review article
C2 - 26304902
AN - SCOPUS:84942235183
SN - 0732-183X
VL - 33
SP - 3018
EP - 3028
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 27
ER -