Most patients with germ cell tumors enjoy an excellent prognosis, so therapeutic investigations focus on the reduction of short- and long-term toxicities; however, the treatment and cure of high-risk and relapsing patients remains the goal of new therapeutic strategies. It is likely that novel agents with promising activity in these diseases will be selected on the basis of improvements in our precise understanding of the molecular biology of germ cell malignancies, as were the disease-specific molecularly targeted therapies for diseases like chronic myelogenous leukemia. Until that time, it will be necessary to continue refining existing techniques (which includes the study of new agents, doses, schedules, and cyto-protective agents) in order to improve the safety and efficacy of high-dose chemotherapy with autologous stem cell support for patients with poor-prognosis germ cell malignancies.
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