Testicular Germ-Cell Tumours · Medical Oncology · Multiply relapsed / platinum-resistant GCT

TPG: paclitaxel, cisplatin and gemcitabine

What activity and long-term outcomes were reported with paclitaxel/cisplatin/gemcitabine beyond second-line salvage?

Retrospective mixed-GCT cohort

Population

Study population as reported in the cited publication; cohort sizes and denominators are stated where available.

Evidence type

Mixed GCT · retrospective

Not all evidence is randomized, comparative, or seminoma-specific.

Reported outcomes

Among 75 patients, 8 (10.7%) achieved CR and 29 (38.7%) achieved marker-negative partial response, giving a major response rate of 49%. Two-year PFS was 14.8% and OS 29.5%. Surgery followed chemotherapy in selected patients.

Major response (CR + marker-negative PR)

37/75

Complete response

8/75

2-year PFS

14.8%

2-year OS

29.5%

Bars visualize source-reported percentages; where the denominator is shown, it is the observed count/denominator rather than a comparative treatment effect. NNT is not calculated for single-arm cohorts or non-randomized comparisons.

Interpretation and limitations

Retrospective later-line data. Survival was substantially better among patients rendered disease-free, highlighting the importance of resection in selected patients. Not seminoma-specific.

Guideline context: ESMO–EURACAN recommends standard-dose VIP/PEI, TIP or VeIP as conventional first salvage options after relapse following cisplatin-based chemotherapy. NCCN Testicular Cancer Guidelines Insights (Version 2.2025) is a contemporary US guideline source. The study summarized here is not necessarily seminoma-specific; histology scope is stated explicitly below.

Guidelines: ESMO–EURACAN 2022 · NCCN Insights v2.2025

Primary study source

Necchi A, Lo Vullo S, Giunti M, et al. Combination of paclitaxel, cisplatin, and gemcitabine (TPG) for multiple relapses or platinum-resistant germ cell tumors: long-term outcomes. Clin Genitourin Cancer. 2014.

Original study / PubMed / registry ↗

Evidence review date: 18 October 2026. Confirm regimen choice and dose schedules against current guideline text and an expert germ-cell tumour multidisciplinary team.