Pediatric and adolescent extracranial germ cell tumors: The road to collaboration

Thomas A. Olson, Matthew J. Murray, Carlos Rodriguez-Galindo, James C. Nicholson, Deborah F. Billmire, Mark D. Krailo, Ha M. Dang, James F. Amatruda, Claire M. Thornton, G. Suren Arul, Sara J. Stoneham, Farzana Pashankar, Daniel Stark, Furqan Shaikh, David M. Gershenson, Allan Covens, Jean Hurteau, Sally P. Stenning, Darren R. Feldman, Peter S. GrimisonRobert A. Huddart, Christopher Sweeney, Thomas Powles, Luiz Fernando Lopes, Simone Dos Santos Agular, Girish Chinnaswamy, Sahar Khaleel, Sherif Abouelnaga, Juliet P. Hale, A. Lindsay Frazier

Research output: Contribution to journalArticle

32 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)3018-3028
Number of pages11
JournalJournal of Clinical Oncology
Volume33
Issue number27
DOIs
StatePublished - Sep 20 2015

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Olson, T. A., Murray, M. J., Rodriguez-Galindo, C., Nicholson, J. C., Billmire, D. F., Krailo, M. D., Dang, H. M., Amatruda, J. F., Thornton, C. M., Arul, G. S., Stoneham, S. J., Pashankar, F., Stark, D., Shaikh, F., Gershenson, D. M., Covens, A., Hurteau, J., Stenning, S. P., Feldman, D. R., ... Frazier, A. L. (2015). Pediatric and adolescent extracranial germ cell tumors: The road to collaboration. Journal of Clinical Oncology, 33(27), 3018-3028. https://doi.org/10.1200/JCO.2014.60.5337