OpenOnco · Treatment Plan

Treatment plan — Testicular germ cell tumor

PLAN-VERIFIED-TESTICULAR-GCT-L2-GCT_SALVAGE_2L_TIP-V1 · v1 · 2026-05-18

Patient

VERIFIED-TESTICULAR-GCT-L2-GCT_SALVAGE_2L_TIP · Algorithm: ALGO-GCT-SALVAGE-2L

DiagnosisTesticular germ cell tumor

MOH / ICD-10C62.9

ICD-O-39061/3; C62.0, C62.1, C62.9

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks

✅ Covered biomarkers (matched in KB)

Biomarker	Variant	ESCAT	Evidence	Clinical significance	Drugs	Sources
No clinically actionable variants matched in this profile.

⚠️ Not included in plan

Biomarker	Status
BIO-AFP	BIO definition in KB; no ESCAT BMA entry — verify with clinician
BIO-HCG-SERUM	Not in KB — ask clinician to verify

Primary current-line option

Standard plan

★ DEFAULT

Indication

IND-GCT-SALVAGE-2L-TIP

Regimen

TIP (paclitaxel + ifosfamide + cisplatin, germ cell tumor salvage)

Drugs + NSZU

Paclitaxel (DRUG-PACLITAXEL) 250 mg/m² IV 24h continuous infusion · Day 1 (24-hour CIV beginning Day 1) · IV ⚠ NSZU — not for this indication
Ifosfamide (DRUG-IFOSFAMIDE) 1.5 g/m²/day IV · Days 2, 3, 4, 5 (4 days) · IV ⚠ NSZU — not for this indication
Cisplatin (DRUG-CISPLATIN) 25 mg/m²/day IV over 60 min · Days 2, 3, 4, 5 (4 days); after ifosfamide each day · IV ⚠ NSZU — not for this indication

Reason

Primary current-line option selected by ALGO-GCT-SALVAGE-2L at step 1.

Other current-line alternatives (1 tracks)

Same treatment line; review when biomarker, access, contraindication, or patient-context assumptions change.

Transplant plan

Indication: IND-GCT-SALVAGE-2L-HDCT-ASCT
Regimen: —
Reason: Current-line alternative presented for HCP consideration

Pre-treatment investigations

Investigations before treatment start · critical / standard / desired · merged across tracks

ID	Name	Priority	Category	Where to order	Needed for
TEST-CBC	Complete Blood Count with Differential	Critical	lab	—	all tracks
TEST-CMP	Comprehensive Metabolic Panel	Critical	lab	—	standard
TEST-LFT	Liver Function Tests (ALT, AST, bilirubin, ALP, GGT, albumin)	Critical	lab	—	all tracks
TEST-CT-CAP	CT chest/abdomen/pelvis	Standard	imaging	—	all tracks
TEST-ECG	Electrocardiogram	Standard	clinical_assessment	—	standard

What NOT to do

Explicit prohibitive rules, each grounded in a regimen / supportive care / contraindication entity

Standard plan (IND-GCT-SALVAGE-2L-TIP)

НЕ застосовувати при цисплатин-рефрактерному захворюванno (прогресія в межах 4 тижnoв від останнього цисплатину) — HDCT+ASCT має перевагу
НІКОЛИ не призначати іфосфамід без мезни — геморагічний цистит
НІКОЛИ не ігнорувати ознаки іфосфамідної енцефалопатії — НЕГАЙНО зупинити + метиленовий сиnoй
Не пропускати базовий рівень маркерів AFP/хГЧ/ЛДГ перед кожним циклом

Transplant plan (IND-GCT-SALVAGE-2L-HDCT-ASCT)

Не відправляти на HDCT при ECOG ≥2 або значnoй органnoй дисфункції — летальnoсть процедури неприйнятна
Не відкладати збір стовбурових клітин — мобілізація G-CSF до першого HDCT циклу
Не застосовувати без спеціалізованого аутоТКМ центру
Не ігнорувати можливість TIP у сприятливому прогностичному сценарії — HDCT не обов'язково 1-я ліnoя рятівної терапії при хорошому прогнозі

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · TIP (paclitaxel + ifosfamide + cisplatin, germ cell tumor salvage)

21-day cycles × 4

MDT brief

Data quality

Complete for MDT review. Required MDT data checks are complete for the current case profile.

Biomarker coverage: 2/2 known (100%), 0 missing, 0 default-track gaps

Technical MDT skill metadata (0/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).

Specialist	skill_id	Version	Last reviewed	Domain
Cellular therapy specialist (CAR-T)	`cellular_therapy_specialist`	v0.1.0	2026-04-25	cellular_therapy
Clinical pharmacist	`clinical_pharmacist`	v0.1.0	2026-04-25	clinical_pharmacy
Hematologist / oncohematologist	`hematologist`	v0.1.0	2026-04-25	hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)	`hematopathologist`	v0.1.0	2026-04-25	hematopathology
Infectious disease / hepatology	`infectious_disease_hepatology`	v0.1.0	2026-04-25	infectious_diseases
Medical oncologist (solid-tumor chemotherapist)	`medical_oncologist`	v0.1.0	2026-04-25	solid_oncology
Molecular geneticist / molecular oncologist	`molecular_geneticist`	v0.1.0	2026-04-25	molecular_oncology
Palliative care	`palliative_care`	v0.1.0	2026-04-25	palliative_care
Pathologist (general)	`pathologist`	v0.1.0	2026-04-25	pathology
Primary care / family physician	`primary_care`	v0.1.0	2026-04-25	primary_care
Psycho-oncologist	`psychologist`	v0.1.0	2026-04-25	psychosocial
Radiation oncologist	`radiation_oncologist`	v0.1.0	2026-04-25	radiation_oncology
Radiologist	`radiologist`	v0.1.0	2026-04-25	diagnostic_imaging
Social worker / case manager	`social_worker_case_manager`	v0.1.0	2026-04-25	psychosocial
Surgical oncologist	`surgical_oncologist`	v0.1.0	2026-04-25	surgical_oncology
Transplant specialist (BMT)	`transplant_specialist`	v0.1.0	2026-04-25	cellular_therapy

Sources cited

SRC-EINHORN-HDCT-ASCT-2007: High-dose chemotherapy and stem-cell rescue for metastatic germ-cell tumors ()
SRC-KONDAGUNTA-TIP-2005: Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors ()

Experimental options (clinical trials)

Third plan track — open-enrollment trials from ClinicalTrials.gov. Render-time metadata; engine selection is not affected by this block (CHARTER §8.3). Last synced: 2026-05-18.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT06276491	Phase 1, Safety and Tolerability Study of XmAb541 in Advanced Solid Tumors	PHASE1	RECRUITING	Xencor, Inc.	—	Phase 1 only Single country
NCT07218913	Testing the Addition of Pedmark to Cisplatin Chemotherapy for Reducing Drug-Induced Ear Damage in Men With Stage II-III Metastatic Testicular Germ Cell Tumors	PHASE1	RECRUITING	City of Hope Medical Center	—	Phase 1 only Small N (<50) Single country
NCT07498959	Primary RPLND Versus Systemic Chemotherapy in Good-prognosis Metastatic Testicular Cancer	NA	RECRUITING	Sahlgrenska University Hospital	—	Single country
NCT02099734	Germ Cell Tumor and Testicular Tumor DNA Registry	N/A	RECRUITING	Memorial Sloan Kettering Cancer Center	—	Single country
NCT07124000	DESTINY-PANTUMOUR04	N/A	RECRUITING	AstraZeneca	—	Surrogate endpoint only Single country
NCT06638931	Agnostic Therapy in Rare Solid Tumors	PHASE2	RECRUITING	Instituto do Cancer do Estado de São Paulo	—	Small N (<50) Single country
NCT07463508	Evaluation of Bile Acid Concentrations and Their Signaling as Markers of Testicular Tumorigenesis and Germ Cell Tumor Chemosensitivity	NA	RECRUITING	University Hospital, Clermont-Ferrand	—	Small N (<50) Single country
NCT07259304	Social Health, Activity Behaviors, and Quality of Life Among Young Adult Cancer Survivors	N/A	RECRUITING	University of Southern California	—	Single country
NCT05670938	Follow-up After Surgery for Testicular Cancer	N/A	RECRUITING	Erasmus Medical Center	—	Single country
NCT07453082	A Prospective Study to Evaluate miRNA371 and Outcomes in Patients With Newly Diagnosed Germ Cell Tumors	N/A	RECRUITING	Fondazione del Piemonte per l'Oncologia	—	Single country

Verify recruitment status directly with the trial site. ctgov data can lag behind current UA-site status.

Option availability in Ukraine

Per-track UA registration · NSZU · cost · access pathway. Render-time metadata; engine selection does not depend on these fields (CHARTER §8.3).

Option	UA registration	NSZU	Cost orientation	Access pathway
Standard plan TIP (paclitaxel + ifosfamide + cisplatin, germ cell tumor salvage) (REG-TIP-GCT-SALVAGE)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Transplant plan — No regimen components on this track — availability unknown	— unknown	— unknown	₴-? — verify pathway	not recorded
Trial · NCT06276491 Phase 1, Safety and Tolerability Study of XmAb541 in Advanced Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07218913 Testing the Addition of Pedmark to Cisplatin Chemotherapy for Reducing Drug-Induced Ear Damage in Men With Stage II-III Metastatic Testicular Germ Cell Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07498959 Primary RPLND Versus Systemic Chemotherapy in Good-prognosis Metastatic Testicular Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT02099734 Germ Cell Tumor and Testicular Tumor DNA Registry No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07124000 DESTINY-PANTUMOUR04 No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06638931 Agnostic Therapy in Rare Solid Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07463508 Evaluation of Bile Acid Concentrations and Their Signaling as Markers of Testicular Tumorigenesis and Germ Cell Tumor Chemosensitivity No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07259304 Social Health, Activity Behaviors, and Quality of Life Among Young Adult Cancer Survivors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05670938 Follow-up After Surgery for Testicular Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07453082 A Prospective Study to Evaluate miRNA371 and Outcomes in Patients With Newly Diagnosed Germ Cell Tumors No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor

Cost information is orientation. Verify with a specific pharmacy / foundation / trial site. Status updated: 2026-05-18.

plan_id: PLAN-VERIFIED-TESTICULAR-GCT-L2-GCT_SALVAGE_2L_TIP-V1 | version: 1 | generated: 2026-05-18T09:53:56.454374+00:00

Per FDA non-device CDS positioning (CHARTER §15): Outpatient oncology treatment planning to support tumor-board discussion. Not a medical device; not for autonomous clinical decision-making.

Per FDA non-device CDS positioning (CHARTER §15): Both treatment options below are presented for review. The engine's selection of a 'recommended' default does not constitute a clinical decision. Final treatment selection requires HCP judgment incorporating information not available to the system.

This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.