Transient tumor marker elevation following chemotherapy for germ cell tumors of the testis

A total of 22 adults with metastatic nonseminomatous germ cell tumor of the testis and raised pretreatment serum levels of the beta subunit of human chorionic gonadotropin (HCG) had serial monitoring of serum HCG by weekly assay following initiation of chemotherapy with bleomycin, etoposide, and cisplatin (BEP). A transient rise in HCG (the marker "surge") was detected in 9 patients (41%), of whom one relapsed. None of the other 13 patients have relapsed (follow-up, 24-60 months), and the BEP regimen overall leads to an 83.3% disease-free survival (Br J Cancer 47:613-619, 1983). The marker surge is not an adverse prognostic factor during initial chemotherapy.