How do you approach treatment options for men with germ cell tumors that relapse within 2 years of initial chemotherapy?

In general, patients who relapse more than 3 months out from initial chemotherapy will respond to platinum-based chemotherapy. I prefer TIP regimens x 2 followed by tandem transplant vs TIP x 4 but I will do the latter in patients who do not get approved for transplant or who are not medically clear...