This protocol addresses patients with non-seminomatous germ cell tumour (NSGCT) and metastatic disease classified in the IGCCCG intermediate prognosis group, for whom prior salvage chemotherapy did not achieve the required response goals.
IGCCCG intermediate prognosis group — all of the following must apply:
Salvage chemotherapy with VIP, TIP, or GIP was administered but did not achieve:
This protocol is the step indicated after that failure.
An intensive high-dose chemotherapy strategy with autologous stem cell support is the approach used at this stage. The complete regimen sequencing, eligibility criteria, and further details are in the full protocol.
Any of the following criteria: Testis/retro-peritoneal primary, No nonpulmonary visceral metastases. And any of the following criteria: AFP 1,000 - 10,000ng/mL or hCG 5,000 - 50,000 IU/L or LDH 1.5-10 x ULN.
HDCT with autologous stem cell support should be used although the prospect of cure is < 25%.
When HDCT is used as a salvage treatment, sequential treatment cycles of high-dose carboplatin and etoposide (HD-CE) should be preferred to a single high-dose regimen as the former is associated with less toxicity-related deaths.
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