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Publisher Summary This chapter describes the salvage therapy in refractory/relapsed germ cell tumors. Approximately 20–30% of patients with advanced germ cell tumors need salvage chemotherapy for refractory or recurrent disease. The reports have shown that the VIP schedule can induce long-term complete remissions in this subset of patients. 22 patients were given VIP as salvage chemotherapy, consisting of etoposide 100 mg/m2iv days 1–5, ifosfamide 1.2 g/m2 iv days 1–5 plus cisplatin 100 mg/m2 iv day 1, every 3 weeks. All patients had already been treated with at least one cisplatin-containing regimen. Thirteen patients had refractory disease, five had relapsed tumors and four had completely resected residual masses containing viable tumor following first-line treatment. The total number of cycles given was 95. Full doses were given in 55 courses. The four patients receiving adjuvant VIP were not evaluated for response. Among valuable patients, 2 achieved CR, 12 showed a partial response, and 4 did not responded. It was found that of the 12 PR patients, 6 were rendered disease-free after surgical resection of residual masses containing mature teratoma/fibrosis or viable tumor.