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The TI-CE regimen is a high-dose chemotherapy protocol consisting of paclitaxel, ifosfamide, carboplatin, and etoposide, used in conjunction with autologous stem cell transplantation (ASCT). This specific sequence, evaluated by the N.N. Petrov National Medical Research Center of Oncology, involves two cycles of TI (paclitaxel and ifosfamide) for stem cell mobilization and three cycles of high-dose CE (carboplatin and etoposide) as consolidation therapy. It is primarily indicated for patients with relapsed or refractory germ cell tumors, particularly those who have failed first-line platinum-based chemotherapy. The regimen's efficacy relies on the synergistic effects of microtubule stabilization (paclitaxel), DNA alkylation (ifosfamide and carboplatin), and topoisomerase II inhibition (etoposide) to overcome the resistance mechanisms typically found in advanced germ cell malignancies.
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