Trial of Gemcitabine, Cisplatin, and Ifosfamide in Patients With Relapsed Non-Seminomatous Germ-Cell Tumors

Inclusion Criteria: * Patients older than 16 years * Histologically-proven disseminated (non stage I) NSGCT, or diagnosis of NSGCT based on very elevated serum human chorionic gonadotropin (HCG) and/or alpha fetoprotein (AFP) * Relapsed disease classified as good prognosis according to the Memorial Sloan-Kettering Cancer Center (MSKCC) classification criteria: * Testicular primary site * Prior treatment limited to one program (or 6 or fewer cycles of cisplatin) * Either a complete response or a partial response with normal serum AFP and HCG * Relapse documented by rising AFP and/or HCG or by a biopsy * No previous carcinoma, except basal-cell carcinoma of the skin * Adequate renal function: measured or calculated creatinine clearance\> 60 ml/min * Absolute granulocyte count \>= 1,500/mm3, platelets \>= 100,000 mm3, bilirubin \< 1.5 fold the upper normal value * Signed informed consent. Exclusion Criteria: * Patients infected by the human immunodeficiency virus (HIV) * Patients who do not fit inclusion criteria