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How would you treat a residual mediastinal mass in patients with a mediastinal germ cell tumor with an incomplete response to primary chemotherapy with BEPx4?

i.e. gross disease on scans that is too diffuse to be removed completely and/or decreasing but not normal markers Do you pursue close surveillance, second line chemotherapy, or surgical resection?
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How would you treat a residual mediastinal mass in patients with a mediastinal germ cell tumor with an incomplete response to primary chemotherapy with BEP x 4?

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1 Answer
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Medical Oncology · Indiana Univ Simon Cancer Center
Answered on

Several comments:

1. VIP is preferred over BEP for PMNSGCT if there will be consideration for extensive mediastinal resection (JCO 34:4445,2016)

2. Patient should be evaluated at a center with experienced and skilled thoracic surgical oncology to determine if patient is truly inoperable.

3. Need more i...

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