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<p>Despite excellent cure rates in first-line and salvage treatment, some patients with germ cell tumors (GST) develop progressive disease even after intensified treatment with high-dose chemotherapy (HDCT). No established standard exists for this treatment-refractory disease situation, the prognosis of patients is generally poor, sustained remission is very rare, and the therapeutic concept is normally palliative. Gemcitabine-based combinations continue to represent the most important systemic option. Immune checkpoint inhibitors have failed to show relevant efficacy in various studies. Classical targeted therapies such as multi-tyrosine kinase or mTOR inhibitors are ineffective in most cases. Some new approaches, including CD30-targeted antibody–drug conjugates as well as claudin-6-targeted chimeric antigen receptor (CAR)&#xa0;T-cell therapies in particular have delivered first indications of clinical activity and new perspectives. The clinical relevance of these novel approaches is currently being assessed in trials.</p>

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Palliative Therapie und neue Therapiekonzepte bei Keimzelltumoren

  • 期刊论文

  • 发表日期：

    2026年2月6日

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  • Anja Lorch

摘要

Despite excellent cure rates in first-line and salvage treatment, some patients with germ cell tumors (GST) develop progressive disease even after intensified treatment with high-dose chemotherapy (HDCT). No established standard exists for this treatment-refractory disease situation, the prognosis of patients is generally poor, sustained remission is very rare, and the therapeutic concept is normally palliative. Gemcitabine-based combinations continue to represent the most important systemic option. Immune checkpoint inhibitors have failed to show relevant efficacy in various studies. Classical targeted therapies such as multi-tyrosine kinase or mTOR inhibitors are ineffective in most cases. Some new approaches, including CD30-targeted antibody–drug conjugates as well as claudin-6-targeted chimeric antigen receptor (CAR) T-cell therapies in particular have delivered first indications of clinical activity and new perspectives. The clinical relevance of these novel approaches is currently being assessed in trials.