Treatment of Malignant Germ Cell Tumor of the Ovary After BEP Chemotherapy Failure

This protocol addresses recurrent or persistent malignant germ cell tumor of the ovary — including dysgerminoma, immature teratoma, embryonal carcinoma, endodermal sinus (yolk sac) tumor, and nongestational choriocarcinoma — in patients where prior chemotherapy did not achieve a complete response.

Clinical Scenario

Malignant germ cell tumors are a distinct group of ovarian malignancies. These malignant tumors include dysgerminomas, immature teratomas, embryonal tumors, and endodermal sinus (yolk sac) tumors. This protocol applies to cases of recurrent or persistent disease following initial treatment.

Previous Treatment Failure

This next-line protocol is indicated when prior BEP-based adjuvant chemotherapy (Bleomycin, Etoposide, Cisplatin) — or carboplatin plus etoposide in select cases — failed to achieve a complete clinical response with normalization of tumor markers (AFP, LDH, β-hCG). Persistent or recurrent disease after this first-line regimen requires a different approach.

Next-Line Treatment (Partial Overview)

For recurrent or persistent disease, options include combination salvage chemotherapy regimens and, for appropriately selected patients, high-dose chemotherapy with hematopoietic cell transplantation at a tertiary care center — considered a potentially curative approach.

Complete regimen options, eligibility criteria, and sequencing are available in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

Malignant germ cell tumors
These malignant tumors include dysgerminomas, immature teratomas, embryonal tumors, and endodermal sinus (yolk sac) tumors.
High-dose chemotherapy + hematopoietic cell transplant (HCT) (strongly recommend referral to tertiary care center for potentially curative regimen)
Second-line chemotherapy (category 2B)

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