Testicular germ cell tumors (TGCTs) mostly affect young men, but fortunately belong to well curable solid tumors. Today, different treatment strategies are applied reaching excellent out-comes and introduction of alternative approach of patient active survilence or adjuvant chemotherapy after orchiectomy decreases number of unnecessary toxic treatments of young patients. Also for relapsing patients, salvage therapy offers high survival rates. However, small percentage of affected young men do not respond to conventional therapy regimen due to intrinsic or acquired therapy resistance. For precise watching of patients during active surveillance, for stratification of patients due to their prognosis, and detection of therapy resistance and early relaps before treatment initiation, reliable molecular biomarkers and diagnostic tools replacing conventional approaches are still needed. Complex understanding of disease development and progression as well as mechanisms of chemoresistance and their epigenetic or chronobiological regulation pre-requisite successfull search for such novel biomarkers. In this review, we aimed to highlight the importance of crosstalk of different regulatory mechanisms and their key players affecting treatment response, and focus on their potential as novel molecular biomarkers and/or druggable targets.
Neoplasma. 2019 Dec 09 [Epub ahead of print]
J Roska, D Jurkovicova
Department of Genetics, Cancer Research Institute, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.