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Abstract：
Testicular germ-cell tumors (TGCT) have been widely recognized for their outstanding survival rates, commonly attributed to their high sensitivity to cisplatin-based therapies. Despite this, a subset of patients develops cisplatin resistance, for whom additional therapeutic options are unsuccessful, and ~20% of them will die from disease progression at an early age. Several efforts have been made trying to find the molecular bases of cisplatin resistance. However, this phenomenon is still not fully understood, which has limited the development of efficient biomarkers and precision medicine approaches as an alternative that could improve the clinical outcomes of these patients. With the aim of providing an integrative landscape, we review the most recent genomic and epigenomic features attributed to chemoresponse in TGCT patients, highlighting how we can seek to combat cisplatin resistance through the same mechanisms by which TGCTs are particularly hypersensitive to therapy. In this regard, we explore ongoing treatment directions for resistant TGCT and novel targets to guide future clinical trials. Through our exploration of recent findings, we conclude that epidrugs are promising treatments that could help to restore cisplatin sensitivity in resistant tumors, shedding light on potential avenues for better prognosis for the benefit of the patients.
摘要：
睾丸生殖细胞肿瘤（TGCT）因其出色的生存率而被广泛认可。通常归因于它们对以顺铂为基础的疗法的高度敏感性。尽管如此,一部分患者出现顺铂耐药，对于其他治疗选择不成功的人，其中约20％将在早期因疾病进展而死亡。已经进行了一些努力以试图找到顺铂抗性的分子基础。然而,这种现象仍然没有得到充分理解，这限制了有效生物标志物和精准医学方法的开发，作为可以改善这些患者临床结局的替代方法。为了提供综合景观，我们回顾了TGCT患者中归因于化学反应的最新基因组和表观基因组特征，强调我们如何通过TGCT对治疗特别过敏的相同机制来对抗顺铂耐药。在这方面,我们探索耐药TGCT的持续治疗方向和新靶点,以指导未来的临床试验.通过我们对最近发现的探索，我们得出的结论是，epidrugs是有希望的治疗方法，可以帮助恢复耐药肿瘤的顺铂敏感性，为患者的利益提供更好的预后的潜在途径。
