First Line TIP in Poor Prognosis TGCTs.

Inclusion Criteria: * Patients older than 16 years. * Evidence of NSGCT based on histologic examination or based on clinical evidence and high serum HCG or AFP levels (in case of clinical emergency, therapy can be started before pathologic sample is obtained if tumor markers are very elevated) * Testicular, retroperitoneal, or mediastinal primary site. * Evidence of disseminated disease (clinical stages II or III). * Disease classified as poor prognosis according to IGCCCG criteria: * Primary mediastinal NSGCT or * Non-pulmonary visceral metastases or * HCG \> 50,000 UI/l, or AFP \> 10,000 ng/ml, or LDH \> 10 times the upper normal value. * No prior chemotherapy. * 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, bilirubine \<= 1.5 fold the upper normal value. * Unfavorable tumor marker decline after 1.cycle of BEP * Signed informed consent. Exclusion Criteria: * Patients infected by the Human Immunodeficiency Virus (HIV). * Patients who do not fit inclusion criteria.