Testicular germ-cell tumours · Medical Oncology · Salvage chemotherapy

Loehrer VIP salvage study

In heavily pretreated or refractory germ-cell tumours, what activity was observed with etoposide, ifosfamide and cisplatin (VIP)?

Histology scope: Mixed GCT · early salvage study. This is not a seminoma-only efficacy estimate.

Study population

48 evaluable

Evidence type

Mixed GCT · early salvage

Reported outcomes

Sixteen of 48 evaluable patients (33%) achieved complete remission with VIP alone or after resection of residual disease. Seven patients remained continuously disease-free; median survival in this highly unfavourable population was 7 months.

Complete remission

16/48

Continuously disease-free

7/48

Source-reported values only. NNT is not applicable to this single-arm or non-randomized evidence.

Interpretation and guideline context

An early study in heavily pretreated patients; the contribution of ifosfamide was uncertain in the original report. It is not a seminoma-specific study and should not be compared directly with modern first-salvage TIP cohorts.

ESMO–EURACAN 2022 lists standard-dose VIP/PEI, TIP or VeIP among first-salvage options after relapse. NCCN Testicular Cancer Guidelines Insights Version 2.2025 is linked as a contemporary guideline source. Neither guideline converts mixed-histology cohorts into seminoma-specific evidence.

ESMO–EURACAN guideline ↗ · NCCN Insights v2.2025 ↗

Primary source

Loehrer PJ Sr, Einhorn LH, Williams SD. VP-16 plus ifosfamide plus cisplatin as salvage therapy in refractory germ cell cancer. J Clin Oncol. 1986;4:528–536.

Original study / PubMed ↗

Evidence review date: 18 October 2026. Full clinical freshness and browser-rendered visual QA remain pending.