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Review Open Access

Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review)

  • Authors:
    • Eleni Solange De Brito Gomes
    • Tainá Miotto De Souza
    • Ana Laura Paiva Oliveira
    • Ana Flavia Souza Peres Bezerra
    • Ingridy Izabella Vieira Cardoso
    • Lenilson Silva
    • Luiz Fernando Lopes
    • Marcela Nunes Rosa
    • Mariana Tomazini Pinto
  • View Affiliations / Copyright

    Affiliations: Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784400, Brazil, Pediatric Oncology Research Group, Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784400, Brazil
    Copyright: © Gomes et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 105
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    Published online on: October 13, 2025
       https://doi.org/10.3892/ijo.2025.5811
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Abstract

Germ cell tumors (GCTs) are rare, heterogeneous neoplasms derived from primordial germ cells. Although they typically develop in the gonads, they may also arise in extragonadal locations along the midline of the body. Approximately 90% of patients respond well to cisplatin‑based chemotherapy; however, ~30% exhibit treatment resistance. Epithelial‑mesenchymal plasticity (EMP), a recognized hallmark of cancer, has been implicated in promoting metastasis and chemoresistance. Nonetheless, studies investigating the specific role of EMP in GCT treatment resistance remain limited. The present review compiles key studies on GCTs, EMP markers and cisplatin resistance using both in vitro and in vivo models; it highlights the roles of associated genes, transcription factors and proteins, identifying potential therapeutic targets. Advancing our understanding of EMP and identifying novel therapeutic targets may support the development of treatment strategies that complement or replace cisplatin. This, in turn, could improve survival outcomes and create new avenues for molecular research and clinical applications.
View Figures

Figure 1

Schematic representation of germ cell
tumor development and its association with EMP. Genetic alterations
in primordial germ cells lead to different tumor subtypes, with EMP
playing a role in organogenesis, tumor progression and metastasis.
Created in BioRender. Souza Peres, A. (2025) https://BioRender.com/g02j275. EMP,
epithelial-to-mesenchymal plasticity; MEP,
mesenchymal-to-epithelial plasticity.

Figure 2

Overview of in vivo GCT models
and key findings on plasticity and cisplatin resistance. Cellular
plasticity pathways, shown in blue, include the genes SNAIL,
SLUG, HIF-1α, N-cadherin and P-cadherin and the
proteins NOTCH1, desmin, laminin and β-integrin. Cisplatin
resistance pathways, in green, involve the TEX11 gene and
the proteins REV7, ErbB1, ErbB2 and ErbB3. SLUG and
vimentin genes are the only plasticity markers linked to
cisplatin resistance in GCTs (in brown). Created in BioRender.
Pinto, M. (2025) https://BioRender.com/z54o788. GCT, germ cell tumor;
HIF-1α, hypoxia-inducible factor 1-α; TEX11,
testis-expressed 11; REV7, reversionless 7.

Figure 3

Graphical representation of EMP
markers, cisplatin resistance and potential inhibitors across GCT
histologies. This figure illustrates the histologies studied both
in vivo and in vitro, including those related to
cisplatin resistance and the status of potential inhibitors for
targeted therapy. Red circles indicate association with cisplatin
resistance. Created in BioRender. Pinto, M. (2025) https://BioRender.com/x70i558.EMP,
epithelial-mesenchymal plasticity; GCT, germ cell tumor; CCND1,
cyclin D1; ErbB, ErbB family; CD133, prominin-1; ALDH3A1, aldehyde
dehydrogenase 3 family member A1; ABCG2, ATP binding cassette
subfamily G member 2; TRIB3, Tribbles pseudokinase 3; IGFBP2,
insulin-like growth factor binding protein 2; NANOG, homeobox
protein NANOG; POU5F1, POU class 5 homeobox 1; SOX2, SRY-related
HMG-box 2; CDK, cyclin-dependent kinase; VIRMA, Vir-like M6A
methyltransferase associated; ACTA2, actin alpha 2; COL1A1, type I
collagen; FN1, fibronectin; HDAC, histone deacetylase; POLD4, DNA
Polymerase Delta 4, Accessory Subunit; TGF-β, transforming growth
factor beta; VIM, vimentin; XPC, XPC complex subunit, DNA damage
recognition and repair factor; NES, nestin; STMN2, stathmin-2;
REV7; reversionless 7; has-miR, Homo sapiens microRNA; ANXA1,
annexin A1; TAGLN, Transgelin; TEXT11, testis-expressed 11;
LINC003131, long intergenic non-coding RNA; PTTG1, pituitary
tumor-transforming gene 1; DAPT,
N-[N-(3,5-Difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl
ester; MLN4924, pevonedistat; MG-132, proteasome inhibitor; PDE4,
phosphodiesterase 4; SENP1, SUMO specific peptidase 1; ILK,
integrin linked kinase; SNAIL, snail family transcriptional
repressor 1; TWIST1, Twist-related protein 1; NAE1, NEDD8
activating enzyme E1 subunit 1; HIF-1α, hypoxia inducible factor 1
Subunit Alpha ; ZEB2, zinc finger E-box binding homeobox 2; HMOX1,
heme oxygenase 1; NOTCH1, notch receptor 1.
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Copy and paste a formatted citation
Spandidos Publications style
Gomes ED, De Souza TM, Oliveira AP, Bezerra AS, Cardoso IV, Silva L, Lopes LF, Rosa MN and Pinto MT: Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review). Int J Oncol 67: 105, 2025.
APA
Gomes, E.D., De Souza, T.M., Oliveira, A.P., Bezerra, A.S., Cardoso, I.V., Silva, L. ... Pinto, M.T. (2025). Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review). International Journal of Oncology, 67, 105. https://doi.org/10.3892/ijo.2025.5811
MLA
Gomes, E. D., De Souza, T. M., Oliveira, A. P., Bezerra, A. S., Cardoso, I. V., Silva, L., Lopes, L. F., Rosa, M. N., Pinto, M. T."Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review)". International Journal of Oncology 67.6 (2025): 105.
Chicago
Gomes, E. D., De Souza, T. M., Oliveira, A. P., Bezerra, A. S., Cardoso, I. V., Silva, L., Lopes, L. F., Rosa, M. N., Pinto, M. T."Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review)". International Journal of Oncology 67, no. 6 (2025): 105. https://doi.org/10.3892/ijo.2025.5811
Copy and paste a formatted citation
x
Spandidos Publications style
Gomes ED, De Souza TM, Oliveira AP, Bezerra AS, Cardoso IV, Silva L, Lopes LF, Rosa MN and Pinto MT: Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review). Int J Oncol 67: 105, 2025.
APA
Gomes, E.D., De Souza, T.M., Oliveira, A.P., Bezerra, A.S., Cardoso, I.V., Silva, L. ... Pinto, M.T. (2025). Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review). International Journal of Oncology, 67, 105. https://doi.org/10.3892/ijo.2025.5811
MLA
Gomes, E. D., De Souza, T. M., Oliveira, A. P., Bezerra, A. S., Cardoso, I. V., Silva, L., Lopes, L. F., Rosa, M. N., Pinto, M. T."Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review)". International Journal of Oncology 67.6 (2025): 105.
Chicago
Gomes, E. D., De Souza, T. M., Oliveira, A. P., Bezerra, A. S., Cardoso, I. V., Silva, L., Lopes, L. F., Rosa, M. N., Pinto, M. T."Epithelial‑mesenchymal plasticity and cisplatin resistance in germ cell tumors: Mechanisms and emerging therapeutic strategies (Review)". International Journal of Oncology 67, no. 6 (2025): 105. https://doi.org/10.3892/ijo.2025.5811
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