Data/hora: 01/06/2024 08:16:02

Provedor de dados: | 56
País: | Brazil
Título: | Intensive chemotherapy as salvage treatment for solid tumors: focus on germ cell cancer
Autores: | Selle,F.; Gligorov,J.; Richard,S.; Khalil,A.; Alexandre,I.; Avenin,D.; Provent,S.; Soares,D.G.; Lotz,J.P.
Data: | 2015-01-01
Ano: | 2015
Palavras-chave: | High-dose chemotherapy; Germ cell tumors; Stem cell transplantation; Solid tumors; Breast cancer; Ovarian cancer.
Resumo: | Germ cell tumors present contrasting biological and molecular features compared to many solid tumors, which may partially explain their unusual sensitivity to chemotherapy. Reduced DNA repair capacity and enhanced induction of apoptosis appear to be key factors in the sensitivity of germ cell tumors to cisplatin. Despite substantial cure rates, some patients relapse and subsequently die of their disease. Intensive doses of chemotherapy are used to counter mechanisms of drug resistance. So far, high-dose chemotherapy with hematopoietic stem cell support for solid tumors is used only in the setting of testicular germ cell tumors. In that indication, high-dose chemotherapy is given as the first or late salvage treatment for patients with either relapsed or progressive tumors after initial conventional salvage chemotherapy. High-dose chemotherapy is usually given as two or three sequential cycles using carboplatin and etoposide with or without ifosfamide. The administration of intensive therapy carries significant side effects and can only be efficiently and safely conducted in specialized referral centers to assure optimum patient care outcomes. In breast and ovarian cancer, most studies have demonstrated improvement in progression-free survival (PFS), but overall survival remained unchanged. Therefore, most of these approaches have been dropped. In germ cell tumors, clinical trials are currently investigating novel therapeutic combinations and active treatments. In particular, the integration of targeted therapies constitutes an important area of research for patients with a poor prognosis.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2015000100013
Editor: | Associação Brasileira de Divulgação Científica
Relação: | 10.1590/1414-431x20144214
Formato: | text/html
Fonte: | Brazilian Journal of Medical and Biological Research  v.48 n.1 2015
Fonte: | info:eu-repo/semantics/openAccess