Mechanisms of cisplatin sensitivity and resistance in testicular germ cell tumors

Ratnakar Singh, Zeeshan Fazal, Sarah J. Freemantle, Michael J. Spinella

Research output: Contribution to journalReview articlepeer-review


Testicular germ cell tumors (TGCTs) are a cancer pharmacology success story with a majority of patients cured even in the highly advanced and metastatic setting. Successful treatment of TGCTs is primarily due to the exquisite responsiveness of this solid tumor to cisplatin-based therapy. However, a significant percentage of patients are, or become, refractory to cisplatin and die from progressive disease. Mechanisms for both clinical hypersensitivity and resistance have largely remained a mystery despite the promise of applying lessons to the majority of solid tumors that are not curable in the metastatic setting. Recently, this promise has been heightened by the realization that distinct (and perhaps pharmacologically replicable) epigenetic states, rather than fixed genetic alterations, may play dominant roles in not only TGCT etiology and progression but also their curability with conventional chemotherapies. In this review, it discusses potential mechanisms of TGCT cisplatin sensitivity and resistance to conventional chemotherapeutics.

Original languageEnglish (US)
Pages (from-to)580-594
Number of pages15
JournalCancer Drug Resistance
Issue number3
StatePublished - 2019


  • Cisplatin
  • DNA methylation
  • Embryonal carcinoma
  • Epigenetics
  • P53
  • Resistance
  • Testicular cancer
  • Testicular germ cell tumors

ASJC Scopus subject areas

  • Cancer Research
  • Pharmacology (medical)


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