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RecruitingNCT06418789GERMANUpdated Aug 3, 2025

High-dose Chemotherapy as Second-line Drug Therapy for Relapsed Germ Cell Tumors

A Phase 2 interventional study of High-dose chemotherapy (TI- 2 cycles, CE- 3 cycles ) in Germ Cell Tumor, sponsored by N.N. Petrov National Medical Research Center of Oncology. Recruiting at 1 site in Russia. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-08-03.

Sponsored by N.N. Petrov National Medical Research Center of Oncology · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Mar 2024; still recruiting 2 years 8 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
18 Years and older
Sex
Male
01

Study summary

This is a prospective, single-center, non-randomized phase II study. Patients with germ cell tumors of gonadal and extragonadal localization who have progressed after prior platinum-containing first-line chemotherapy will receive high-dose chemotherapy with TI (2 cycles) folollowed by high dose CE chemotherapy with autologous stem cell transplantation (3 cycles). The primary endpoint of the study is to evaluate the efficacy high-dose chemotherapy as second-line drug therapy for patients with advanced germ cell tumors.

Read the detailed description

Germ cell tumors are curable diseases. Only a small proportion of patients fail to be cured: those who experience a primary resistance to chemotherapy and those who relapsed after first line conventional dose cisplatin-based chemotherapy. Nowadays, there is heterogeneity of practice in salvage approaches. This includes conventional chemotherapy high dose chemotherapy with autologous stem cell transplant. Best choice of the therapy strategy is an unmet clinical need now. This is why this single-center, non-randomized phase II study will be conducted at the N.N. Petrov National Medical Research Center of Oncology. Patients with germ cell tumors of gonadal and extragonadal localization who have progressed after prior platinum-containing first-line chemotherapy will receive two cycles of high-dose TI (Paclitaxel 200mg/m² on day 1, Ifosfamide 2000mg/m² daily from days 1 to 3 of 14-day cycle. G-CSF 10 micrograms/Kg SC daily day on days 6-14 day or until CD34 harvest; leukapheresis will be performed starting on day 11 in case of CD45+CD34+ blood level above 20x10\^6/L is achieved), followed by three cycles of high dose CE (Carboplatin AUC=8 IV daily days -4 to -2, Etoposide 400mg/m\^2 IV daily days -4 to -2, autlologous stem cell transplantation at day 0, GCSF support from day 4.) The primary endpoint of the study is to evaluate the efficacy by measuring progression-free survival. The secondary endpoints of the trial are overall survival, response rate by RECIST, safety and prognostic factors analysis.

02

Conditions studied

  • Germ Cell Tumor

Keywords

  • Germ Cell Tumor
  • Teratoma
  • Choriocarcinoma
  • Germinoma
  • Childhood Teratoma
  • Extragonadal Seminoma
  • Seminoma
  • Non-seminomatous Germ Cell Tumor
  • Yolk Sac Tumor
  • Mixed Germ Cell Tumor
  • Malignant Germ Cell Neoplasm
03

In context

Neoplasms, Germ Cell and Embryonal

166 studies on the registry are indexed under Neoplasms, Germ Cell and Embryonal; 48 are open to participants now.

This study's planned enrollment of 25 is below the median of 36 across 124 interventional studies indexed under Neoplasms, Germ Cell and Embryonal.

Browse Neoplasms, Germ Cell and Embryonal studies →

Lead sponsor

N.N. Petrov National Medical Research Center of Oncology is the lead sponsor of 27 studies on the registry; 15 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patient is able to provide and sign approved consent forms to participate in the study.
  2. Males ≥ 18 years of age at the time of signing the IC Form.
  3. verified diagnosis of GO (seminomatous, non-seminomatous).

2. Any (gonadal and extragonadal (retroperitoneal, mediastinal, etc.)) localization of primary GO.

3. Progression after 3 or 4 cycles of platinum-containing chemotherapy (ВЕР or EP).

4. Required Initial Laboratory Values:

  • ≥ 90 g/L;
  • neutrophils ≥ 1.5 x 109/L;
  • ≥ 75 x 109/L;
  • creatinine ≥ 1.5 x HGH (or CKF ≤ 60 mL/min);
  • or AST ≥ 2.5 x HGN (5 x HGN for patients with liver );
  • ≥ 1.5 x IUH (except for patients with Gilbert syndrome, in whom total bilirubin levels should not exceed 50 μmol/L);
  • alkaline phosphatase ≥ 2.5 x IUH. 5. Absence of neurologic symptoms in the presence of (asymptomatic CNS metastases are acceptable).

Exclusion criteria

Exclusion Criteria:

  1. Primary CS of the brain
  2. Administration of ≥2 lines of prior drug therapy for disseminated GO.
  3. Presence of active or , infection, acute infectious disease, or activation of chronic infectious disease less than 28 days prior to study inclusion.
  4. Conditions that limit the patient's ability to fulfill the requirements of the protocol (psychiatric disorders, drug or alcohol dependence).
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    Group 1

    In arm patients receive a TI-CE regime based on paclitaxel and ifosfamide in cycles 1-2 and carboplatin and etoposide in cycles 3-5.

    Drug: High-dose chemotherapy (TI- 2 cycles, CE- 3 cycles )

Interventions

  • DrugHigh-dose chemotherapy (TI- 2 cycles, CE- 3 cycles )

    TI: Paclitaxel 200mg/m² on day 1, Ifosfamide 2000mg/m² daily from days 1 to 3 of 14-day cycle. G-CSF 10 micrograms/Kg SC daily day on days 6-14 day or until CD34 harvest. Leukapheresis will be performed starting on day 11 in case blood level of CD45+CD34+ above 20x10\^6/L is achieved. CE: Carboplatin AUC=8 IV daily days -4 to -2, Etoposide 400mg/m\^2 IV daily days -4 to -2, autlologous stemm cell transplantation \>=2\*10\^6/Kg at day 0, GCSF support from day 4 until the recovery of neutrophils above 1\*10\^9/L. Patients will receive two cycles of TI followed by 3 cycles of CE in case at least 6\*10\^6 CD34+ stem cells will be harvested.

06

What researchers measure

Primary outcomes

  1. Progression Free Survival (PFS)

    Progression Free Survival 2-year

    Time frame: Up to 24 months post-treatment

Secondary outcomes

  1. Overall survival (OS)

    Overall survival (OS) 3-year

    Time frame: Up to 36 months post-treatment

  2. Incidence of adverse events

    All toxicities will be evaluated and recorded based on the NCI Common Terminology Criteria for Adverse Events (CTCAE v5.0).

    Time frame: Up to 3 months post-therapy discontinuation

  3. Validation of International Prognostic Factor Study Group stratification system

    Evaluation of the efficacy of high-dose TI (2 cycles)-CE (3 cycles) chemotherapy in patients with germ cell tumors of gonadal and extragonadal localization who progressed after prior platinum-containing first-line chemotherapy and received high-dose TI (2 cycles)-CE (3 cycles) chemotherapy, depending on the prognosis group (IGCCCG classification (1997), IGCCCG Update Model (2021)).

    Time frame: Up to 3 years post-registration

  4. Assessment of patients' quality of life

    European Organization for the Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) is a 30-question tool used to assess the overall quality of life (QoL) in cancer participants. It consisted of 15 domains: 1 global health status (GHS) scale, 5 functional scales (Physical, role, cognitive, emotional, social), and 9 symptom scales/items (Fatigue, nausea and vomiting, pain, dyspnoea, sleep disturbance, appetite loss, constipation, diarrhea, financial impact. The EORTC QLQ-C30 GHS/QoL score ranges from 0 to 100; High score indicates better GHS/QoL. Score 0 represents: very poor physical condition and QoL. Score 100 represents: excellent overall physical condition and QoL.

    Time frame: also during the 5-year follow-up period.

  5. Possibilities of rehabilitation

    Evaluation of the impact of patient nutritional support and the relationship between patient nutrition and the incidence of non-hematologic complications (mucositis, colitis, infectious complications)

    Time frame: also during the 5-year follow-up period.

  6. Assessment of the possibility of improving mobilization rates with the drug "Plerixafor"

    In case of poor mobilization according to the criteria of the European Society of Bone Marrow Transplantation, the addition of Plerixafor at a dose of 24 mg to the mobilization is envisaged. An evaluation of the feasibility of improving mobilization rates with Plerixafor is planned.

    Time frame: 2 months

  7. Response Rate

    Incidence of complete, partial response, stable and progressive disease by RECIST 1.1 system

    Time frame: Every 8 weeks up to 6 months

07

Study locations

1 of 1 sites recruiting
  • National Medical Research Center of Oncology named after N.N.Petrov Ministry of health of Russia
    Saint Petersburg, Russian Federation 197758, Russia
    Recruiting
    • Anna I Semenova, MD, PhD · Contact
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 3, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06418789
Lead sponsor
N.N. Petrov National Medical Research Center of Oncology
Responsible party
Anna Igorevna Semenova (clinical oncologist, N.N. Petrov National Medical Research Center of Oncology) — Principal investigator
First posted
May 17, 2024
Start date
Mar 1, 2024
Primary completion
Mar 1, 2029 (estimated)
Completion
Mar 1, 2029 (estimated)
Last update
Aug 3, 2025

Study contacts

Anna Semenova, MD, PhD
Contact
mirannia@yandex.ru
8 (812) 439-95-05
Aleksei M Belyaev, MD,DSc,Prof.
study director · National Medical Research Center of Oncology named after N.N.Petrov Ministry of health of Russia
Tatyana Yu Semiglazova, MD,DSc,Prof.
study chair · National Medical Research Center of Oncology named after N.N.Petrov Ministry of health of Russia

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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