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Impact of Circulating Tumor DNA and Copy-Number Alterations on Clinical Outcome in Relapsed/Refractory Germ Cell Tumors Treated With Salvage High-Dose Chemotherapy - PubMed

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  • #Germ Cell Tumors
  • #Circulating Tumor DNA
  • #High-Dose Chemotherapy
  • High-dose chemotherapy (HDCT) is a salvage therapy for relapsed/refractory germ cell tumors (rGCT).
  • Circulating tumor DNA (TF) and copy-number alterations (CNAs) were analyzed to predict clinical outcomes.
  • High baseline TF was associated with worse overall survival (OS) in HDCT-treated nonseminomas.
  • Specific CNA patterns (e.g., 3p gain, 9q/11q gains, 6q loss) were linked to poor HDCT outcomes.
  • A high-risk CNA cluster, enriched in extra-embryonic histology (yolk sac, choriocarcinoma), showed worse progression-free survival (PFS) and OS.
  • HDCT was more effective than conventional-dose chemotherapy (CDCT) in high-TF patients.
  • Minimally invasive biomarkers (TF, CNAs) can refine risk stratification and guide salvage therapy selection.