Biomarkers for Salvage Therapy in Testicular Germ Cell Tumors

Int J Mol Sci. 2023 Nov 28;24(23):16872. doi: 10.3390/ijms242316872.


The outcome of metastatic testicular germ cell tumor patients has been dramatically improved by cisplatin-based chemotherapy combinations. However, up to 30% of patients with advanced disease relapse after first-line therapy and require salvage regimens, which include treatments with conventional-dose chemotherapy or high-dose chemotherapy with autologous stem cell transplantation. For these patients, prognosis estimation represents an essential step in the choice of medical treatment but still remains a complex challenge. The available histological, clinical, and biochemical parameters attempt to define the prognosis, but they do not reflect the tumor's molecular and pathological features and do not predict who will exhibit resistance to the several treatments. Molecular selection of patients and validated biomarkers are highly needed in order to improve current risk stratification and identify novel therapeutic approaches for patients with recurrent disease. Biomolecular biomarkers, including microRNAs, gene expression profiles, and immune-related biomarkers are currently under investigation in testicular germ cell tumors and could potentially hold a prominent place in the future treatment selection and prognostication of these tumors. The aim of this review is to summarize current scientific data regarding prognostic and predictive biomarkers for salvage therapy in testicular germ cell tumors.

Keywords: biomarkers; germ cell tumors; immunotherapy; microRNA; molecular alterations; salvage therapy; testicular cancers.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers
  • Cisplatin / therapeutic use
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Male
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasms, Germ Cell and Embryonal* / diagnosis
  • Neoplasms, Germ Cell and Embryonal* / genetics
  • Neoplasms, Germ Cell and Embryonal* / therapy
  • Salvage Therapy
  • Testicular Neoplasms* / drug therapy
  • Testicular Neoplasms* / therapy
  • Transplantation, Autologous


  • Cisplatin
  • Biomarkers

Supplementary concepts

  • Testicular Germ Cell Tumor

Grants and funding

This work was partly supported by the contribution of Ricerca Corrente by the Italian Ministry of Health within the research line “Precision, gender and ethnicity-based medicine and geroscience: genetic-molecular mechanisms in the development, characterization and treatment of tumors”.