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For patients with relapse after cisplatin\u2010based therapy, treatment is still curative in approximately 50% of the cases. Management options for these patients include surgery, radiotherapy and use of conventional dose or high\u2010dose chemotherapy (HDCT). Therefore, treatment of relapsed or refractory patients is complex and there is no uniformly accepted approach available. Data comparing conventional dose and HDCT in the first salvage therapy is limited to one randomized trial which was not able to ultimately define optimal treatment. More recently, a large retrospective analysis of nearly 1600 patients not only identified prognostic factors in relapse, but retrospectively suggested a 10\u201315% benefit regarding overall survival for patients receiving HDCT plus autologous stem cell transplantation over patients receiving conventional\u2010dose chemotherapy. Prognosis in multiply relapsed and primary cisplatin\u2010refractory patients is generally poor. Currently, a number of mechanisms of cisplatin resistance and potential drug targets like global methylation and BRAF mutation status are under investigation in refractory GCT.<\/jats:p>","DOI":"10.1111\/j.1365-2605.2011.01145.x","type":"journal-article","created":{"date-parts":[[2011,7,26]],"date-time":"2011-07-26T17:08:38Z","timestamp":1311700118000},"source":"Crossref","is-referenced-by-count":22,"title":["Treatment of patients with relapsed and\/or cisplatin\u2010refractory metastatic germ cell tumours: an 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