Treatment of Seminoma Stage IIB–III with IGCCCG Intermediate Prognosis and Non-Pulmonary Visceral Metastases

This protocol targets a specific subset of advanced seminoma: stage IIB–III disease classified as IGCCCG intermediate prognosis, defined by the presence of non-pulmonary visceral metastases alongside normal serum AFP. The IGCCCG classification directly informs treatment intensity in this setting.

Clinical scenario

Seminoma stage IIB–III with IGCCCG intermediate prognosis classification: non-pulmonary visceral metastases confirmed, serum AFP within normal range, any hCG level, any LDH level, patient fit for cisplatin-based chemotherapy. Cisplatin-based chemotherapy stratified by IGCCCG classification is standard care for seminoma stage IIB–IIC and III.

Treatment approach

The regimen for this group centres on high-dose chemotherapy. The full protocol — specifying agents, cycle count, and clinical sequencing — is available in the structured evidence-based regimen below.

Complete algorithm, dosing framework, and eligibility details are behind the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2022.01.002

Three cycles of BEP represents the standard therapy for seminoma patients categorised as good prognosis and four cycles of BEP for intermediate prognosis.

Cisplatin-based ChT according to the IGCCCG classification is standard for seminoma stage IIB-IIC and III.

HD-ChT should be employed in third-line therapy, if not already used earlier, and might still cure selected patients in this setting.

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