OnCo

Testicular germ cell tumours: lines of therapy

Cancer page →

5 standard-of-care settings across 3 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersIMDC risk
Early / localised2·
Advanced, first line11
Second line1·

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersStage I seminomaOrchiectomy then surveillance (preferred); adjuvant carboplatin AUC 7 ×1 or para-aortic radiotherapy for those declining surveillance.81
All comersStage I non-seminomaSurveillance (relapse ~15-50% by LVI status, all salvageable); or BEP ×1 or nerve-sparing RPLND for high-risk.81

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersMetastatic, IGCCCG good riskBEP ×3 or EP ×4; post-chemotherapy RPLND for residual non-seminoma masses >1 cm.81
IMDC riskMetastatic, intermediate/poor riskBEP ×4 (or VIP if bleomycin contraindicated); early marker-decline assessment to intensify (GETUG-13); brain metastases treated multimodally.81

Second line

SubgroupSettingApproachProducts and trialsEvidence
All comersRelapsedTIP or VeIP conventional-dose salvage, or high-dose carboplatin-etoposide with autologous stem-cell rescue (TI-CE); TIGER phase 3 compares the two; late relapse and teratoma need surgery.81

Regimens in the library

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.