VIP

Say it: V-I-P (or VIP)

Etoposide, ifosfamide and cisplatin

VIP is a 5 day chemotherapy for testicular and other germ cell cancers, often used in place of BEP when bleomycin is not safe for the lungs.

Also called: VIP chemo, VIP x 4, etoposide ifosfamide cisplatin, VeIP, PEI

What it is

Germ cell cancers are very sensitive to chemotherapy, even when they have spread. VIP uses ifosfamide in place of bleomycin, which spares the lungs. The goal is cure, even for many people with advanced disease.

Often used for

• testicular cancer (germ cell tumor) with intermediate or poor risk features
• germ cell tumors when bleomycin cannot be used because of lung problems
• germ cell tumors of the chest or other sites

VeIP (salvage treatment)

Vinblastine replaces etoposide for germ cell cancer that came back after first treatment.

VIP before a stem cell transplant

In some cancers that come back, VIP is used to shrink the cancer before high dose chemotherapy with a stem cell transplant.

The medicines in this plan

Etoposide

Chemotherapy that stops cancer cells from copying DNA. Given through a vein on days 1 to 5.

Ifosfamide

Chemotherapy that damages cancer cell DNA. Given through a vein on days 1 to 5.

Cisplatin

Platinum chemotherapy. Given through a vein on days 1 to 5 with lots of IV fluids to protect the kidneys.

Mesna

Protects the bladder from ifosfamide. Given through a vein with each ifosfamide dose.

How you get it

VIP is given over 5 days in a row, either in the hospital or with daily long clinic visits, and repeats every 21 days. Most people get 4 cycles, about 3 months. Each day includes several hours of IV fluids. A white blood cell booster shot is given after each cycle. Your schedule may be different.

A typical cycle

Before starting

Blood tests, tumor marker tests, hearing test, and sperm banking if desired.

Days 1 to 5

IV fluids, then etoposide, ifosfamide with mesna, and cisplatin each day, plus anti-nausea medicines.

Days 6 to 8

White blood cell booster shots begin. Nausea and tiredness may peak.

Days 8 to 15

Blood counts are lowest, so infection and bleeding risk are highest. Transfusions may be needed.

Days 15 to 21

Counts recover. Blood tests and tumor markers before the next cycle.

Common side effects and what helps

• Very low blood counts. Many people need a blood or platelet transfusion.
• Nausea and vomiting, which may last several days after cisplatin. Take your anti-nausea medicines on schedule.
• Tiredness, often the worst in the second week.
• Hair loss. It grows back after treatment.
• Ringing in the ears or hearing loss from cisplatin. Report any change in hearing.
• Tingling in fingers and toes from cisplatin.
• Kidney strain and low magnesium or potassium. Drink fluids; your team checks blood and gives replacements.
• Confusion or sleepiness from ifosfamide, usually short lived.

Call your care team right away if you have

• A fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or chills
• Confusion, extreme sleepiness, seeing things that are not there, or a seizure
• Blood in the urine or pain when urinating
• Vomiting that will not stop, or you cannot keep fluids down
• Making much less urine than usual
• Bleeding, many new bruises, or tiny red spots on the skin
• Sudden hearing loss or ringing in the ears
• Shortness of breath or chest pain

Good to know

• Chemotherapy can cause infertility. Sperm banking before starting is strongly encouraged.
• Cisplatin and ifosfamide can harm the kidneys, so you get lots of IV fluids and frequent kidney blood tests.
• Ifosfamide can irritate the bladder and affect the brain; mesna and close watching help prevent problems.
• Hearing may be tested before and during treatment.
• Tumor markers (blood tests such as AFP and HCG) are checked each cycle to track response.

At home

• Drink 8 to 12 cups of fluid a day between cycles unless your team says otherwise.
• Take your anti-nausea pills on schedule for several days after each cycle.
• Check your temperature twice a day when your counts are low.
• Give your booster shots as instructed, or keep your clinic visits for them.
• Avoid crowds and sick people when counts are low.

Questions to ask

• Why is VIP better for me than BEP?
• Will I stay in the hospital for each cycle?
• How will we track whether it is working?
• Will I need surgery afterward to remove any leftover tumor?
• How can I protect my fertility?

Testicular cancer

Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.