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J Clin Oncol. 2015 Sep 20;33(27):3018-28. doi: 10.1200/JCO.2014.60.5337. Epub 2015 Aug 24.

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

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1
Thomas A. Olson, Emory University, Atlanta, GA; Matthew J. Murray and James C. Nicholson, Cambridge University Hospitals National Health Service (NHS) Foundation Trust, Cambridge, United Kingdom; Carlos Rodriguez-Galindo and A. Lindsay Frazier, Boston Children's Hospital, Boston; Carlos Rodriguez-Galindo, A. Lindsay Frazier, and Christopher Sweeney, Dana-Farber Cancer Institute, Boston, MA; Deborah F. Billmore, Riley Hospital for Sick Children, Indianapolis, IN; Mark D. Krailo and Ha M. Dang, University of Southern California, Los Angeles, CA; James F. Amatruda, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas; David M. Gershenson, University of Texas MD Anderson Cancer Center, Houston, TX; Claire M. Thornton, Royal Victoria Hospital, Belfast, United Kingdom; G. Suren Arul, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom; Sara J. Stoneham, University College London Hospitals NHS Foundation Trust, London, United Kingdom; Farzana Pashankar, Yale University School of Medicine, New Haven, CT; Daniel Stark, University of Leeds, Leeds, United Kingdom; Furqan Shaikh, The Hospital for Sick Children, Toronto; Allan Covens, University of Toronto, Toronto, Ontario, Canada; Jean Hurteau, University of Chicago Pritzker School of Medicine, Chicago, IL; Sally P. Stenning, Medical Research Council, London, United Kingdom; Darren R. Feldman, Memorial Sloan Kettering Cancer Center, New York, NY; Peter S. Grimison, Sydney Cancer Center, Sydney, New South Wales, Australia; Robert A. Huddart, Institute of Cancer Research and Royal Marsden Hospital, Surrey, United Kingdom; Thomas Powles, Barts Cancer Institute, London, United Kingdom; Luiz Fernando Lopes, Barretos Pediatric Cancer Center, São Paulo, Brazil; Simone dos Santos Agular, Centro Infantil Boldrini, Campinas, Brazil; Girish Chinnaswamy, Tata Memorial Hospital, Mumbai, India; Sahar Khaleel and Sherif Abouelnaga, Children's Cancer Hospital, Cairo, Egypt; and Jul

Erratum in

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.

PMID:
26304902
PMCID:
PMC4979195
DOI:
10.1200/JCO.2014.60.5337
[Indexed for MEDLINE]
Free PMC Article

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