Central nervous system germ cell tumours (germinoma and non-germinomatous): lines of therapy
5 standard-of-care settings across 4 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Localised germinoma | Platinum-based chemotherapy (carboplatin and etoposide, with ifosfamide in the SIOP schedule) followed by reduced-dose whole-ventricular irradiation with a tumour boost (SIOP CNS GCT II, ACNS1123); craniospinal irradiation alone remains an alternative in adults. | NCI PDQ: childhood CNS germ cell tumours | 93 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Disseminated germinoma | Craniospinal irradiation with boosts, with or without chemotherapy. | NCI PDQ: childhood CNS germ cell tumours | 93 |
Second line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Relapse | High-dose chemotherapy (thiotepa-based) with autologous stem cell rescue, with re-irradiation where possible. | 87 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Non-germinomatous germ cell tumour | Intensive cisplatin or carboplatin, etoposide and ifosfamide chemotherapy, second-look surgery for residual disease, then craniospinal or whole-ventricular irradiation depending on stage and response (ACNS0122, ACNS1123, SIOP CNS GCT II). | NCI PDQ: childhood CNS germ cell tumours | 93 | |
| All comers | Teratoma | Complete surgical resection; growing teratoma after chemotherapy is also managed surgically. | 40 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.