The purpose of the study is to see whether using indocyanine green during surgery helps the team find and remove more lymph nodes (small glands that are part of the body’s immune system) and whether this changes the surgery in any helpful or harmful way. Some patients will have surgery with the dye and the special light imaging, while others will have the same type of surgery without it. The study includes operations such as nephroureterectomy (removal of a kidney and the tube that carries urine from it) and retroperitoneal lymph node dissection (removal of lymph nodes from the back part of the abdomen).

During the study, the dye is given before or during surgery, and the surgical team then carries out the planned operation and removes tissue as needed. After surgery, the medical team checks for any side effects from the dye and watches for usual surgery-related problems during recovery. The study also looks at how the surgery went overall and how well the dye appeared to help during the procedure.

The purpose of this study is to evaluate how well this treatment with tumor-infiltrating lymphocytes works in patients with germ cell tumors that have not responded to previous treatments. The study will look at whether the tumors shrink, disappear, or stop growing, and will also measure certain substances in the blood called tumor markers that indicate cancer activity.

During the study, a piece of tumor tissue will first be removed from the patient through surgery or by taking small samples called biopsies. This tumor tissue will be used to grow the patient’s own immune cells in the laboratory. Once enough cells have been grown, the patient will receive the preparatory chemotherapy medicines, followed by the infusion of the grown immune cells, and then the immune-supporting medicine. The study will monitor patients for side effects and will regularly check the status of their tumors using imaging scans and blood tests to measure tumor markers and overall health.

The study aims to determine if this combination of medications can help prevent the cancer from growing or spreading in patients who have already undergone at least two previous rounds of chemotherapy. The treatment will be given through intravenous administration and will continue for up to 24 months, depending on how well patients respond to the therapy.

During the study, patients will receive regular doses of both medications. Cisplatin will be given at doses up to 100 milligrams per square meter of body surface area, while dornase alfa will be administered at doses up to 125 micrograms per kilogram of body weight. The effectiveness of this treatment will be evaluated primarily by measuring how long patients remain without their disease getting worse.

The treatment involves several medications, including Paclitaxel, Mesna, Etoposide, Cisplatin, Lenograstim, Oxaliplatin, Ifosfamide, Carboplatin, and Bleomycin. These medications are administered through infusions or injections, and their use is tailored to each patient’s needs. The study also includes the use of a placebo to compare the effects of the actual medications. The trial will monitor the progression of the disease and the overall survival of the participants, as well as any side effects experienced during the treatment.

Participants will undergo regular assessments to track their response to the treatment, including the use of MRI scans to check for any spread of the cancer to the brain. The study will also evaluate the quality of life of the participants using specific questionnaires. The goal is to provide a comprehensive understanding of how these treatments can improve the health and well-being of patients with this challenging type of cancer.

The purpose of the study is to determine if Carboplatin is as effective as Cisplatin in treating patients with these tumors. Participants in the study will receive either Carboplatin or Cisplatin and will be monitored over time to see how well the treatment works. The study will look at how long patients remain free from cancer events, such as tumor growth or recurrence, and will also consider overall survival rates.

Throughout the study, researchers will also assess the safety of the treatments by monitoring any side effects or adverse reactions. Additionally, the study will evaluate other factors such as the number of hospital days required during treatment and the need for blood transfusions. The trial is expected to continue until 2028, providing valuable information on the best treatment options for patients with Malignant Extracranial Germ Cell Tumors.