Loading
Testicular germ cell tumours are the most curable adult solid cancer: cisplatin-based chemotherapy cures the large majority even when the disease has spread to distant sites. Today's research is about giving less treatment to the majority who are cured, rescuing the minority who relapse, and limiting lifelong survivorship harms.
Testicular germ cell tumours (GCTs) are seminomas or non-seminomas (embryonal carcinoma, yolk sac tumour, choriocarcinoma, teratoma, mixed), arising from germ cell neoplasia in situ, almost universally carrying 12p gain (i(12p)). Serum tumour markers (AFP, hCG, LDH) stage and monitor the disease; miR-371a-3p is a more sensitive marker entering practice. The IGCCCG classification (1997, updated 2021) divides metastatic disease into good, intermediate and poor prognosis with 5-year survival of ~95%, ~90% and ~65-70%.
Orchiectomy is followed by surveillance for most stage I disease; adjuvant carboplatin (seminoma) or one cycle of BEP (non-seminoma) are options for high-risk stage I. Metastatic disease receives BEP ×3 (good risk) or ×4 (intermediate/poor), or EP ×4 when bleomycin is contraindicated; residual masses after chemotherapy in non-seminoma are resected (retroperitoneal lymph node dissection). Relapse is treated with conventional-dose salvage (TIP, VeIP) or high-dose chemotherapy with autologous stem-cell rescue (TI-CE); the TIGER trial directly compares these. Survivorship (cardiovascular risk, second cancers, hypogonadism, infertility, ototoxicity, neuropathy) is a central concern because patients live 50+ years after cure.
The most common cancer in men aged 15-40; about 75,000 cases per year worldwide (GLOBOCAN) with cure rates above 95% overall and ~80% even in metastatic disease.
Germ cell tumours drain along the spermatic cord to the para-aortic nodes high in the abdomen, not to the groin, which is why staging scans look at the retroperitoneum.
Same organ: Retroperitoneal germ cell tumour, Leydig cell tumour of the testis, Sertoli cell tumour of the testis, Spermatocytic tumour of the testis, Germ cell neoplasia in situ (GCNIS), Embryonal carcinoma of the testis, Yolk sac tumour of the testis, postpubertal type, Choriocarcinoma of the testis, Seminoma, Non-seminomatous germ cell tumour, Germ cell tumours of childhood and adolescence (extracranial and CNS)
Nothing recorded yet.
Nothing recorded yet.
Background: Alpha-fetoprotein (AFP). Also on OnCo: Symptoms and red flags · Early detection roadmap.
Orchiectomy then surveillance (preferred); adjuvant carboplatin AUC 7 ×1 or para-aortic radiotherapy for those declining surveillance.
Surveillance (relapse ~15-50% by LVI status, all salvageable); or BEP ×1 or nerve-sparing RPLND for high-risk.
BEP ×3 or EP ×4; post-chemotherapy RPLND for residual non-seminoma masses >1 cm.
BEP ×4 (or VIP if bleomycin contraindicated); early marker-decline assessment to intensify (GETUG-13); brain metastases treated multimodally.
TIP 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.
Country and place are remembered in this browser only. A postcode is sent to OpenStreetMap's Nominatim service to find coordinates when you press the button; nothing else leaves your device.
Query for this cancer: (TITLE:"Testicular germ cell tumours" OR ABSTRACT:"Testicular germ cell tumours" OR TITLE:"Seminoma" OR ABSTRACT:"Seminoma" OR TITLE:"Non-seminomatous germ cell tumour" OR ABSTRACT:"Non-seminomatous germ cell tumour" OR TITLE:"NSGCT" OR ABSTRACT:"NSGCT") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Testicular germ cell tumours, not a curated reading list.
Cure rates in metastatic disease jump from ~10% to ~60-70%.
Etoposide substitutes vinblastine with better efficacy and less neurotoxicity.
Updated in 2021 with LDH and age refinements.
The targets of this cancer's medicines and the ones linked to it directly.
| Target / alteration | Prevalence | Measure | Source |
|---|---|---|---|
| Claudin 6 | 90% | IHC positivity |
How common each drug target or alteration is in this cancer. Population-level and approximate; see the target page for detail. Full matrix.
Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes.
One section per setting: the options named, what each is for, the trials behind them, the recorded trade-offs and the questions to ask.
Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
Pulmonary toxicity rises with G-CSF, high inspired oxygen, renal impairment and age over 40.
Reduce for CrCl below 50.
Dose by Calvert formula using GFR (see the calculators).
Dose reduce or avoid for CrCl below 60 (carboplatin is the alternative).
Reduce to 75% for CrCl 15-50.
See all on the product pages:BleomycinCarboplatinCisplatinEtoposideIfosfamidePaclitaxel / nab-paclitaxel·Printable cards in the navigator
Newly diagnosed? Read the first 60 days with Testicular germ cell tumours, then print the one-page appointment sheet with room for the answers.
Print this page for your appointment (your browser's print command). These prompts are for discussion; your clinical team knows your case.
Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record.
Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked.