How many cycles of BEP would you treat an immature teratoma of the ovary?

Assuming we are discussing a grade 2 or 3 stage I IT or stage II-IV IT, the standard of care would be to provide 4 cycles of BEP (although some have advocated for 3 cycles of BEP for low risk disease and 4 for high risk disease). (Brown et al., PMID 25341580) Following this, if tumor markers are still elevated, would obtain additional imaging to clarify if there is any residual/new disease.

If there is residual disease, then options would include surgical resection (preferred to determine if there are only mature benign elements i.e. growing teratoma syndrome) vs transition to a different regimen (TIP) or high dose chemotherapy.

If there is no residual disease noted on imaging and tumor markers are still elevated, I would advocate for surve...