Modified PEI first-salvage cohort
Can dose-modified cisplatin, etoposide and ifosfamide (PEI) achieve durable outcomes as first salvage chemotherapy for male germ-cell tumours?
Histology scope: Male GCT · long-term cohort. This is not a seminoma-only efficacy estimate.
Reported outcomes
In a long-term cohort treated with modified PEI, 35/189 (18.5%) achieved complete response to chemotherapy alone and 67/189 (35.4%) achieved marker-negative partial response. Overall disease-free status after chemotherapy and selected surgery was 76/189 (40.2%); 2-year PFS was 34.3% and 5-year OS 42.1%.
Source-reported values only. NNT is not applicable to this single-arm or non-randomized evidence.
Interpretation and guideline context
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.
Primary source
Modified cisplatin, etoposide, and ifosfamide (PEI) salvage therapy for male germ cell tumors: long-term efficacy and safety outcomes. Ann Oncol. 2013.
Evidence review date: 18 October 2026. Full clinical freshness and browser-rendered visual QA remain pending.