NCCN Guidelines® Insights: Testicular Cancer, Version 2.2025

Featured Updates to the NCCN Guidelines

Authors:
Timothy Gilligan Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute

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Daniel W. Lin Fred Hutchinson Cancer Center

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Nabil Adra Indiana University Melvin and Bren Simon Comprehensive Cancer Center

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Aditya Bagrodia UC San Diego Moores Cancer Center

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Darren R. Feldman Memorial Sloan Kettering Cancer Center

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Kosj Yamoah Moffitt Cancer Center

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Rahul Aggarwal UCSF Helen Diller Family Comprehensive Cancer Center

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Thenappan Chandrasekar UC Davis Comprehensive Cancer Center

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Daniel Costa UT Southwestern Simmons Comprehensive Cancer Center

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Alexandra Drakaki UCLA Jonsson Comprehensive Cancer Center

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Scott Eggener The UChicago Medicine Comprehensive Cancer Center

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Hamid Emamekhoo University of Wisconsin Carbone Cancer Center

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Daniel M. Geynisman Fox Chase Cancer Center

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Laura Graham University of Colorado Cancer Center

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Peter Humphrey Yale Cancer Center/Smilow Cancer Hospital

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Harshraj Leuva Fred & Pamela Buffett Cancer Center

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Ellis G. Levine Roswell Park Comprehensive Cancer Center

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Amy Luckenbaugh Vanderbilt-Ingram Cancer Center

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Benjamin L. Maughan Huntsman Cancer Institute at the University of Utah

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Bradley McGregor Dana-Farber/Brigham and Women’s Cancer Center

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Paul Monk The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute

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Joel Picus Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine

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Phillip Pierorazio Abramson Cancer Center at the University of Pennsylvania

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Soroush Rais-Bahrami O’Neal Comprehensive Cancer Center at UAB

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Zachery Reichert University of Michigan Rogel Cancer Center

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Jean-Claude Rwigema Mayo Clinic Comprehensive Cancer Center

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Philip Saylor Mass General Cancer Center

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Ankeet Shah Duke Cancer Institute

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Sumit Shah Stanford Cancer Institute

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Nirmish Singla Johns Hopkins Kimmel Cancer Center

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Kanishka Sircar The University of Texas MD Anderson Cancer Center

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David VanderWeele Robert H. Lurie Comprehensive Cancer Center of Northwestern University

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Ali Zhumkhawala City of Hope National Medical Center

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Sarah Montgomery National Comprehensive Cancer Network

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Bailee Sliker National Comprehensive Cancer Network

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The NCCN Guidelines for Testicular Cancer provide recommendations for the multidisciplinary approach to the diagnostic workup, treatment, and follow-up for testicular germ cell tumors, including both seminoma and nonseminoma. These NCCN Guidelines Insights discuss the current treatment recommendations and supporting clinical data for seminomas as presented in Version 2.2025 of the NCCN Guidelines for Testicular Cancer.

Provided content development and/or authorship assistance

Timothy Gilligan, Daniel W. Lin, Nabil Adra, Aditya Bagrodia, Darren R. Feldman, Kosj Yamoah, Sarah Montgomery, and Bailee Sliker

The full and most current version of these NCCN Guidelines is available at NCCN.org.

NCCN CATEGORIES OF EVIDENCE AND CONSENSUS

Category 1: Based upon high-level evidence (≥1 randomized phase 3 trials or high-quality, robust meta-analyses), there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate.

Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate.

Category 2B: Based upon lower-level evidence, there is NCCN consensus (≥50%, but <85% support of the Panel) that the intervention is appropriate.

Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.

All recommendations are category 2A unless otherwise indicated.

NCCN CATEGORIES OF PREFERENCE

Preferred intervention: Interventions that are based on superior efficacy, safety, and evidence; and, when appropriate, affordability.

Other recommended intervention: Other interventions that may be somewhat less efficacious, more toxic, or based on less mature data; or significantly less affordable for similar outcomes.

Useful in certain circumstances: Other interventions that may be used for selected patient populations (defined with recommendation).

All recommendations are considered appropriate.

NCCN recognizes the importance of clinical trials and encourages participation when applicable and available. Trials should be designed to maximize inclusiveness and broad representative enrollment.

PLEASE NOTE

The NCCN Guidelines® are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment.

The NCCN Guidelines® Insights highlight important changes in the NCCN Guidelines® recommendations from previous versions. Colored markings in the algorithm show changes and the discussion aims to further understanding of these changes by summarizing salient portions of the panel’s discussion, including the literature reviewed.

The NCCN Guidelines Insights do not represent the full NCCN Guidelines; further, the National Comprehensive Cancer Network® (NCCN®) makes no representations or warranties of any kind regarding the content, use, or application of the NCCN Guidelines and NCCN Guidelines Insights and disclaims any responsibility for their application or use in any way.

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