Katarína Rejleková
Germ cell cancer, which formed 95 % of testicular cancer (also occurring in other extragonadal sites as well), represents
a model of successful, highly treatable malignancy, with 10-year survival rate in 95% of patients. The therapeutic approach
depends on histological findings in primary tumour, primary location and extent of disease. Despite success in treatment
of advanced germ cell cancer, 20 to 30 % of patients relapse after some time or do not achieve complete remission
with standard induction cisplatin-based chemotherapy. 2/3 of all relapses are patients with complete response
to primary chemotherapy, 1/3 are patients refractory to induction chemotherapy. Both groups of patients need effective
second-line treatment. Combination of BEP/EP regimen represents a standard treatment for advanced non-seminomas/
seminomas, but there is still a question mark for the best suitable second-line regimen. For this reason, our article
deals with current options in therapy for patients with relapsed or refractory germ cell cancer. Nowadays there are
three opportunities in salvage regimens: conventional, high dose chemotherapy and new experimental agents. Inevitable
surgical approach after salvage chemotherapy is a necessary component of complete intervention after the completed
cytostatic treatment.