Salvage or savage chemotherapy for poor-risk or relapsed testis cancer-20 years later, not much has changed

摘要

Twenty years ago, Ellis Levine and I reviewed the data on salvage chemotherapy for poor-risk and relapsed testicular cancer and, despite the rhetoric of that time, concluded that high-dose therapy remained of unproven benefit [1]. The thoughtful review by Simonelli et al. [2] in this issue of Annals of Oncology has stimulated me to reconsider our position.This review has addressed the strengths and weaknesses of the various high-dose approaches carefully and has concluded that high-dose chemotherapy cannot be advocated for patients with poor-risk disease, as primary or consolidative therapy, based on published phase III results [3-5], a view that I completely support. Given that I may have a broad audience, I wish publically to congratulate Motzer and Daugaard and their teams for having completed randomized clinical trials that actuaEy 'tested' their hypotheses in a scientifically rigorous fashion.