Testicular cancer

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Except for primary treatment for stage I disease, these regimens are generally applicable to seminoma and non-seminoma histologies.

16 regimens on this page
23 variants on this page

Contents


Guidelines

ESMO

NCCN

Primary treatment for stage I seminoma

Carboplatin monotherapy

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Regimen #1

Study Evidence Comparator Efficacy
Oliver et al. 2005 (MRC TE19/EORTC 30982) Phase III Radiation therapy Seems to have noninferior RFS

Chemotherapy

  • Carboplatin (Paraplatin) AUC 7 IV once on day 1
    • AUC 7 was described in Oliver et al. 2005 & Oliver et al. 2011 as [7 x (GFR + 25)] mg. eGFR was calculated by EDTA; if CrCl via 24-hour urine collection was used, 90% of the [7 x (GFR + 25)] mg dose was used. The Calvert formula for carboplatin dosing is: Dose (mg) = (target AUC) x (GFR + 25).

One-time dose

Regimen #2, 2 doses carboplatin

Study Evidence
Aparicio et al. 2005 (Second Spanish Germ Cell Cancer Group study) Non-randomized
Aparicio et al. 2011 (Third Spanish Germ Cell Cancer Group study) Non-randomized

Patients with stage I seminoma and local risk factors:

  1. Tumor greater than 4 cm
  2. Rete testis invasion

Patients in Aparicio et al. 2005 had at least one risk factor; patients in Aparicio et al. 2011 had at both risk factors.

Chemotherapy

Supportive medications

21-day cycle for 2 cycles

References

  1. Calvert AH, Newell DR, Gumbrell LA, O'Reilly S, Burnell M, Boxall FE, Siddik ZH, Judson IR, Gore ME, Wiltshaw E. Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol. 1989 Nov;7(11):1748-56. link to original article contains verified formula PubMed
  2. Oliver RT, Mason MD, Mead GM, von der Maase H, Rustin GJ, Joffe JK, de Wit R, Aass N, Graham JD, Coleman R, Kirk SJ, Stenning SP; MRC TE19 collaborators and the EORTC 30982 collaborators. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet. 2005 Jul 23-29;366(9482):293-300. link to original article contains verified protocol PubMed
    1. Update: Oliver RT, Mead GM, Rustin GJ, Joffe JK, Aass N, Coleman R, Gabe R, Pollock P, Stenning SP. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol. 2011 Mar 10;29(8):957-62. Epub 2011 Jan 31. link to original article contains verified protocol PubMed
  3. Aparicio J, Germà JR, García del Muro X, Maroto P, Arranz JA, Sáenz A, Barnadas A, Dorca J, Gumà J, Olmos D, Bastús R, Carles J, Almenar D, Sánchez M, Paz-Ares L, Satrústegui JJ, Mellado B, Balil A, López-Brea M, Sánchez A; Second Spanish Germ Cell Cancer Cooperative Group. Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol. 2005 Dec 1;23(34):8717-23. Epub 2005 Oct 31. link to original article contains verified protocol PubMed
  4. Aparicio J, Maroto P, del Muro XG, Gumà J, Sánchez-Muñoz A, Margelí M, Doménech M, Bastús R, Fernández A, López-Brea M, Terrassa J, Meana A, del Prado PM, Sastre J, Satrústegui JJ, Gironés R, Robert L, Germà JR. Risk-adapted treatment in clinical stage I testicular seminoma: the third Spanish Germ Cell Cancer Group study. J Clin Oncol. 2011 Dec 10;29(35):4677-81. Epub 2011 Oct 31. link to original article contains verified protocol PubMed

Radiation therapy

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Regimen

Study Evidence Comparator Efficacy
Oliver et al. 2005 (MRC TE19/EORTC 30982) Phase III Carboplatin Seems to have noninferior RFS

Details are available in the reference.

References

  1. Oliver RT, Mason MD, Mead GM, von der Maase H, Rustin GJ, Joffe JK, de Wit R, Aass N, Graham JD, Coleman R, Kirk SJ, Stenning SP; MRC TE19 collaborators and the EORTC 30982 collaborators. Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet. 2005 Jul 23-29;366(9482):293-300. link to original article contains verified protocol PubMed
    1. Update: Oliver RT, Mead GM, Rustin GJ, Joffe JK, Aass N, Coleman R, Gabe R, Pollock P, Stenning SP. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). J Clin Oncol. 2011 Mar 10;29(8):957-62. Epub 2011 Jan 31. link to original article contains verified protocol PubMed

Primary treatment

BEP

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BEP: Bleomycin, Etoposide, Platinol (Cisplatin)

Regimen #1, "standard" BEP x 3

Study Evidence Comparator Efficacy
Einhorn et al. 1989 Phase III BEP x 4 Seems to have equivalent DFS
de Wit et al. 2001 Phase III BEP x 4 Equivalent PFS
BEP, 3-day etoposide x 3
BEP, 3-day etoposide x 4
Equivalent PFS

Chemotherapy

21-day cycle for 3 cycles

Regimen #2, "standard" BEP x 4

Study Evidence Comparator Efficacy
Einhorn et al. 1989 Phase III BEP x 3 Seems to have equivalent DFS
Nichols et al. 1998 Phase III VIP Seems not superior
de Wit et al. 2001 Phase III BEP x 3 Equivalent PFS
BEP, 3-day etoposide x 3
BEP, 3-day etoposide x 4
Equivalent PFS
Culine et al. 2008 (T93MP) Phase III CISCA/VB Seems not superior

Chemotherapy

  • Bleomycin (Blenoxane) 30 units IV bolus once per day on days 1, 8, 15
    • Note: de Wit et al. 2001 only used bleomycin for cycles 1 to 3
  • Etoposide (Vepesid) 100 mg/m2 in 500 mL normal saline IV over 30 to 60 minutes once per day on days 1 to 5
  • Cisplatin (Platinol) 20 mg/m2 IV over 30 to 60 minutes once per day on days 1 to 5

Supportive medications

  • (as described in Nichols et al. 1998):
  • Normal saline 100 mL/hour IV over 12 hours prior to Cisplatin (Platinol)
  • Normal saline 100 mL/hour IV throughout the 5 day course of Cisplatin (Platinol), ending 6 hours after each cycle's last cisplatin dose
  • G-CSF 5 mcg/kg SC once per day on days 7, 9 to 14, 16, 17

21-day cycle for 4 cycles

Regimen #3

Study Evidence Comparator Efficacy
Williams et al. 1987 Phase III BVP Seems to have superior OS

Patients in Williams et al. 1987 had "advanced germ-cell tumors considered to be unsuitable for local therapy were eligible and included those with either testicular or extragonadal primary tumors. Patients with seminoma were eligible only if radiation therapy was considered to be inappropriate in their cases.

Chemotherapy

Supportive medications

21-day cycle for 4 cycles

Regimen #4, 3-day etoposide x 3

Study Evidence Comparator Efficacy
de Wit et al. 2001 Phase III BEP x 3
BEP x 4
Equivalent PFS
BEP, 3-day etoposide x 4 Equivalent PFS

Chemotherapy

21-day cycle for 3 cycles

Regimen #5, 3-day etoposide x 4

Study Evidence Comparator Efficacy
de Wit et al. 2001 Phase III BEP x 3
BEP x 4
Equivalent PFS
BEP, 3-day etoposide x 3 Equivalent PFS

Chemotherapy

21-day cycle for 4 cycles

References

  1. Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med. 1987 Jun 4;316(23):1435-40. link to original article contains verified protocol PubMed
  2. Einhorn LH, Williams SD, Loehrer PJ, Birch R, Drasga R, Omura G, Greco FA. Evaluation of optimal duration of chemotherapy in favorable-prognosis disseminated germ cell tumors: a Southeastern Cancer Study Group protocol. J Clin Oncol. 1989 Mar;7(3):387-91. link to original article PubMed
    1. Update: Saxman SB, Finch D, Gonin R, Einhorn LH. Long-term follow-up of a phase III study of three versus four cycles of bleomycin, etoposide, and cisplatin in favorable-prognosis germ-cell tumors: the Indiana University experience. J Clin Oncol. 1998 Feb;16(2):702-6. link to original article contains verified protocol PubMed
  3. Nichols CR, Catalano PJ, Crawford ED, Vogelzang NJ, Einhorn LH, Loehrer PJ. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol. 1998 Apr;16(4):1287-93. link to original article contains verified protocol PubMed content property of HemOnc.org
  4. de Wit R, Roberts JT, Wilkinson PM, de Mulder PH, Mead GM, Fosså SD, Cook P, de Prijck L, Stenning S, Collette L. Equivalence of three or four cycles of bleomycin, etoposide, and cisplatin chemotherapy and of a 3- or 5-day schedule in good-prognosis germ cell cancer: a randomized study of the European Organization for Research and Treatment of Cancer Genitourinary Tract Cancer Cooperative Group and the Medical Research Council. J Clin Oncol. 2001 Mar 15;19(6):1629-40. link to original article contains verified protocol PubMed
  5. Culine S, Kramar A, Théodore C, Geoffrois L, Chevreau C, Biron P, Nguyen BB, Héron JF, Kerbrat P, Caty A, Delva R, Fargeot P, Fizazi K, Bouzy J, Droz JP; Genito-Urinary Group of the French Federation of Cancer Centers Trial T93MP. Randomized trial comparing bleomycin/etoposide/cisplatin with alternating cisplatin/cyclophosphamide/doxorubicin and vinblastine/bleomycin regimens of chemotherapy for patients with intermediate- and poor-risk metastatic nonseminomatous germ cell tumors: Genito-Urinary Group of the French Federation of Cancer Centers Trial T93MP. J Clin Oncol. 2008 Jan 20;26(3):421-7. link to original article contains verified protocol PubMed

BVP

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BVP: Bleomycin, Vinblastine, Platinol (Cisplatin)

Regimen

Study Evidence Comparator Efficacy
Williams et al. 1987 Phase III BEP Seems to have inferior OS

Included for historical purposes, only.

Chemotherapy

Supportive medications

21-day cycle for 4 cycles

References

  1. Williams SD, Birch R, Einhorn LH, Irwin L, Greco FA, Loehrer PJ. Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med. 1987 Jun 4;316(23):1435-40. link to original article contains verified protocol PubMed

C-BOP/BEP

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C-BOP: Cisplatin, Bleomycin, Oncovin (Vincristine), Paraplatin (Carboplatin)
BEP: Bleomycin, Etoposide, Platinol (Cisplatin)

Regimen

Study Evidence
Fosså et al. 2005 (EORTC 30948) Phase II

Part 1: C-BOP

14-day cycle for 2 cycles, followed by:

Part 2: BO

14-day cycle for 1 cycle, followed by:

Part 3: Modified BEP

21-day cycle for 3 cycles

References

  1. Fosså SD, Paluchowska B, Horwich A, Kaiser G, de Mulder PH, Koriakine O, van Oosterom AT, de Prijck L, Collette L, de Wit R; EORTC GU Group. Intensive induction chemotherapy with C-BOP/BEP for intermediate- and poor-risk metastatic germ cell tumours (EORTC trial 30948). Br J Cancer. 2005 Nov 28;93(11):1209-14. contains verified protocol link to PMC article PubMed

EP

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EP: Etoposide, Platinol (Cisplatin)

Regimen

Study Evidence Comparator Efficacy
Bosl et al. 1988 Phase III VAB-6 Seems not superior
Bajorin et al. 1993 Phase III EC Seems to have superior EFS

Chemotherapy

21-day cycle for 4 cycles

References

  1. Bosl GJ, Geller NL, Bajorin D, Leitner SP, Yagoda A, Golbey RB, Scher H, Vogelzang NJ, Auman J, Carey R, Fair WR, Herr H, Morse M, Sogani P, Whitmore W. A randomized trial of etoposide + cisplatin versus vinblastine + bleomycin + cisplatin + cyclophosphamide + dactinomycin in patients with good-prognosis germ cell tumors. J Clin Oncol. 1988 Aug;6(8):1231-8. link to original article PubMed
    1. Update: Xiao H, Mazumdar M, Bajorin DF, Sarosdy M, Vlamis V, Spicer J, Ferrara J, Bosl GJ, Motzer RJ. Long-term follow-up of patients with good-risk germ cell tumors treated with etoposide and cisplatin. J Clin Oncol. 1997 Jul;15(7):2553-8. link to original article contains verified protocol PubMed
  2. Bajorin DF, Sarosdy MF, Pfister DG, Mazumdar M, Motzer RJ, Scher HI, Geller NL, Fair WR, Herr H, Sogani P, Sheinfeld J, Russo P, Vlamis V, Carey R, Vogelzang NJ, Crawford ED, Bosl GJ. Randomized trial of etoposide and cisplatin versus etoposide and carboplatin in patients with good-risk germ cell tumors: a multiinstitutional study. J Clin Oncol. 1993 Apr;11(4):598-606. link to original article PubMed
    1. Update: Xiao H, Mazumdar M, Bajorin DF, Sarosdy M, Vlamis V, Spicer J, Ferrara J, Bosl GJ, Motzer RJ. Long-term follow-up of patients with good-risk germ cell tumors treated with etoposide and cisplatin. J Clin Oncol. 1997 Jul;15(7):2553-8. link to original article contains verified protocol PubMed
  3. Retrospective: Kondagunta GV, Bacik J, Bajorin D, Dobrzynski D, Sheinfeld J, Motzer RJ, Bosl GJ. Etoposide and cisplatin chemotherapy for metastatic good-risk germ cell tumors. J Clin Oncol. 2005 Dec 20;23(36):9290-4. link to original article contains verified protocol PubMed

VIP

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VIP: Vepesid (Etoposide), Ifosfamide, Platinol (Cisplatin)

Regimen

Study Evidence Comparator Efficacy
Nichols et al. 1998 Phase III BEP Seems not superior

Chemotherapy

Supportive medications

  • Mesna (Mesnex) 120 mg/m2 IV slow push on day 1 before Ifosfamide (Ifex), then 1200 mg/m2/day IV continuous infusion on days 1 to 5 (though not clearly specified in Nichols et al. 1998, based on its use with ifosfamide, it is assumed that the mesna dose was 1200 mg/m2/day)
  • Normal saline 100 mL/hour IV over 12 hours prior to Cisplatin (Platinol)
  • Normal saline 100 mL/hour IV throughout the 5 day course of Cisplatin (Platinol), ending 6 hours after each cycle's last cisplatin dose
  • G-CSF 5 mcg/kg SC once per day on days 7 to 16

21-day cycle for 4 cycles

References

  1. Nichols CR, Catalano PJ, Crawford ED, Vogelzang NJ, Einhorn LH, Loehrer PJ. Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol. 1998 Apr;16(4):1287-93. link to original article contains verified protocol PubMed

Second line & later treatment

Carboplatin & Etoposide, then auto HSCT

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Regimen

Study Evidence
Nichols et al. 1989 Phase I/II
Einhorn et al. 2007 Retrospective

Note: the doses here are the ones from the retrospective NEJM article, not from the prospective phase I/II trial.

High-dose chemotherapy

  • Carboplatin (Paraplatin) 700 mg/m2 IV once per day on days -5, -4, -3
  • Etoposide (Vepesid) 750 mg/m2 IV once per day on days -5, -4, -3
  • At least 1 million CD34+ cells per kilogram of body weight was needed for each cycle of chemotherapy.

2 cycles, with the second cycle starting after "recovery of granulocyte and platelet counts"

"Most patients" who had complete or partial remission after two cycles of therapy received maintenance therapy:

Maintenance therapy

28-day cycle for 3 cycles

References

  1. Nichols CR, Tricot G, Williams SD, van Besien K, Loehrer PJ, Roth BJ, Akard L, Hoffman R, Goulet R, Wolff SN, Giannone L, Greer J, Einhorn LH, Jansen J. Dose-intensive chemotherapy in refractory germ cell cancer--a phase I/II trial of high-dose carboplatin and etoposide with autologous bone marrow transplantation. J Clin Oncol. 1989 Jul;7(7):932-9. link to original article PubMed
  2. Retrospective: Einhorn LH, Williams SD, Chamness A, Brames MJ, Perkins SM, Abonour R. High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors. N Engl J Med. 2007 Jul 26;357(4):340-8. link to original article contains verified protocol PubMed

Cisplatin & Epirubicin

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CIS-EPI: CISplatin, EPIrubicin

Regimen

Study Evidence
Bedano et al. 2006 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 4 cycles

References

  1. Bedano PM, Brames MJ, Williams SD, Juliar BE, Einhorn LH. Phase II study of cisplatin plus epirubicin salvage chemotherapy in refractory germ cell tumors. J Clin Oncol. 2006 Dec 1;24(34):5403-7. link to original article contains verified protocol PubMed

GemOx

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GEMOX: GEMcitabine, OXaliplatin

Regimen

Study Evidence
Pectasides et al. 2004 Phase II

Chemotherapy

Supportive medications

21-day cycle for up to 6 cycles

References

  1. Pectasides D, Pectasides M, Farmakis D, Aravantinos G, Nikolaou M, Koumpou M, Gaglia A, Kostopoulou V, Mylonakis N, Skarlos D. Gemcitabine and oxaliplatin (GEMOX) in patients with cisplatin-refractory germ cell tumors: a phase II study. Ann Oncol. 2004 Mar;15(3):493-7. link to original article contains verified protocol PubMed

Gemcitabine, Oxaliplatin, Paclitaxel

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GOP: Gemcitabine, Oxaliplatin, Paclitaxel

Regimen

Study Evidence
Bokemeyer et al. 2007 Phase II

Chemotherapy

Supportive medications

21-day cycles, given for 2 cycles beyond the best response, up to a maximum of 8 cycles

References

  1. Bokemeyer C, Oechsle K, Honecker F, Mayer F, Hartmann JT, Waller CF, Böhlke I, Kollmannsberger C; German Testicular Cancer Study Group. Combination chemotherapy with gemcitabine, oxaliplatin, and paclitaxel in patients with cisplatin-refractory or multiply relapsed germ-cell tumors: a study of the German Testicular Cancer Study Group. Ann Oncol. 2008 Mar;19(3):448-53. Epub 2007 Nov 15. link to original article contains verified protocol PubMed

Gemcitabine & Paclitaxel

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Regimen #1

Study Evidence
Hinton et al. 2002 (ECOG E9897) Phase II

Chemotherapy

Supportive medications

28-day cycle for up to 6 cycles

Regimen #2

Study Evidence
Einhorn et al. 2007 Phase II

Chemotherapy

Supportive medications

28-day cycle for up to 6 cycles

References

  1. Hinton S, Catalano P, Einhorn LH, Loehrer PJ Sr, Kuzel T, Vaughn D, Wilding G. Phase II study of paclitaxel plus gemcitabine in refractory germ cell tumors (E9897): a trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 2002 Apr 1;20(7):1859-63. link to original article contains verified protocol PubMed
  2. Einhorn LH, Brames MJ, Juliar B, Williams SD. Phase II study of paclitaxel plus gemcitabine salvage chemotherapy for germ cell tumors after progression following high-dose chemotherapy with tandem transplant. J Clin Oncol. 2007 Feb 10;25(5):513-6. link to original article contains verified protocol PubMed

TI-CE, then auto HSCT

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TI-CE: Taxol (Paclitaxel), Ifosfamide, Carboplatin, Etoposide

Regimen

Study Evidence
Kondagunta et al. 2007 Phase II

Chemotherapy, TI portion

Supportive medications

Stem cell collection

  • Leukapheresis on days 11 to 13 (done on cycle 1, and then only if needed on cycle 2 to have at least 6 x 106 CD34+ cells/kg body weight in peripheral blood stem cells)

14-day cycle for 2 cycles, followed by:

Chemotherapy, CE, then auto HSCT portion

  • Carboplatin (Paraplatin) AUC 7 to 8 IV over 20 to 60 minutes once per day on days 1 to 3
  • Etoposide (Vepesid) 400 mg/m2 IV once per day on days 1 to 3
  • Peripheral blood stem cell support (at least 2 x 106 CD34+ cells/kg body weight per infusion) on day 5, 48 hours after carboplatin & etoposide (stem cells were infused each cycle)

14 to 21-day cycle for 3 cycles

References

  1. Kondagunta GV, Bacik J, Sheinfeld J, Bajorin D, Bains M, Reich L, Deluca J, Budnick A, Ishill N, Mazumdar M, Bosl GJ, Motzer RJ. Paclitaxel plus Ifosfamide followed by high-dose carboplatin plus etoposide in previously treated germ cell tumors. J Clin Oncol. 2007 Jan 1;25(1):85-90. link to original article contains verified protocol PubMed

TIP

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TIP: Taxol (Paclitaxel), Ifosfamide, Platinol (Cisplatin)

Regimen

Study Evidence
Kondagunta et al. 2005 Phase II

Chemotherapy

Supportive medications

21-day cycle for 4 cycles

References

  1. Kondagunta GV, Bacik J, Donadio A, Bajorin D, Marion S, Sheinfeld J, Bosl GJ, Motzer RJ. Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol. 2005 Sep 20;23(27):6549-55. link to original article contains verified protocol PubMed

VeIP

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VeIP: Velban (Vinblastine), Ifosfamide, Platinol (Cisplatin)

Regimen

Study Evidence
Loehrer et al. 1988 Phase II
Loehrer et al. 1998 Phase II

Patients in Loehrer et al. 1998 had previously received cisplatin & etoposide based combination chemotherapy.

Chemotherapy

Supportive medications

  • Mesna (Mesnex) 400 mg/m2 IV bolus on day 1 prior to first dose of Ifosfamide (Ifex), then 1200 mg/m2/day IV continuous infusion on days 1 to 5
  • Normal saline 100 mL/hour IV continuous infusion on days 1 to 5

21-day cycle for 4 cycles

References

  1. Loehrer PJ Sr, Lauer R, Roth BJ, Williams SD, Kalasinski LA, Einhorn LH. Salvage therapy in recurrent germ cell cancer: ifosfamide and cisplatin plus either vinblastine or etoposide. Ann Intern Med. 1988 Oct 1;109(7):540-6. link to original article PubMed
  2. Loehrer PJ Sr, Gonin R, Nichols CR, Weathers T, Einhorn LH. Vinblastine plus ifosfamide plus cisplatin as initial salvage therapy in recurrent germ cell tumor. J Clin Oncol. 1998 Jul;16(7):2500-4. link to original article contains verified protocol PubMed

Oxaliplatin & Bevacizumab

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Regimen

Study Evidence
Jain et al. 2014 Phase II

Chemotherapy

14-day cycle for a maximum of 14 cycles

References

  1. Jain A, Brames MJ, Vaughn DJ, Einhorn LH. Phase II clinical trial of oxaliplatin and bevacizumab in refractory germ cell tumors. Am J Clin Oncol. 2014 Oct;37(5):450-3. link to original article PubMed

Sunitinib monotherapy

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Regimen #1

Study Evidence
Feldman et al. 2010 Phase II

Chemotherapy

Regimen #2

Study Evidence
Oechsle et al. 2011 Phase II

Chemotherapy

42-day cycles

References

  1. Feldman DR, Turkula S, Ginsberg MS, Ishill N, Patil S, Carousso M, Bosl GJ, Motzer RJ. Phase II trial of sunitinib in patients with relapsed or refractory germ cell tumors. Invest New Drugs. 2010 Aug;28(4):523-8. link to original article contains verified protocol PubMed
  2. Oechsle K, Honecker F, Cheng T, Mayer F, Czaykowski P, Winquist E, Wood L, Fenner M, Glaesener S, Hartmann JT, Chi K, Bokemeyer C, Kollmannsberger C. Preclinical and clinical activity of sunitinib in patients with cisplatin-refractory or multiply relapsed germ cell tumors: a Canadian Urologic Oncology Group/German Testicular Cancer Study Group cooperative study. Ann Oncol. 2011 Dec;22(12):2654-60. Epub 2011 Mar 17. link to original article PubMed

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