Combination Chemotherapy and Pegfilgrastim in Treating Patients With Previously Untreated Germ Cell Tumors

DISEASE CHARACTERISTICS:

Histologically confirmed germ cell tumor meeting 1 of the following criteria:

Poor risk, defined by any of the following:

Testis or retroperitoneal primary site nonseminoma histology without visceral metastases but with "poor-risk" markers, defined by any of the following:

Pretreatment serum lactate dehydrogenase (LDH) > 10 times upper limit of normal (ULN)
Pretreatment serum human chorionic gonadotropin (HCG) > 50,000 IU/L
Pretreatment serum alpha fetoprotein (AFP) > 10,000 ng/mL

Testis or retroperitoneal primary site nonseminoma histology with one or more nonpulmonary visceral metastases, including any of the following (regardless of serum tumor marker values):

Bone metastases
Brain metastases
Hepatic metastases
Any nonpulmonary metastases (i.e., skin, spleen)
Mediastinal primary site nonseminoma histology regardless of serum tumor marker levels or presence/absence of visceral metastases

Modified intermediate risk, defined by any of the following:

Testis or retroperitoneal primary site nonseminoma histology with no nonpulmonary visceral metastases, and with any of the following serum marker values:

Pretreatment serum LDH 3.0-10 times ULN
Pretreatment serum HCG 5,000-50,000 IU/L
Pretreatment serum AFP 1,000-10,000 ng/mL

Seminoma histology with one or more nonpulmonary visceral metastases, including any of the following (regardless of serum tumor marker values or primary site):

Bone metastases
Brain metastases
Hepatic metastases
Any nonpulmonary visceral metastases (i.e., skin, spleen)
Previously untreated disease
Measurable or evaluable disease

PATIENT CHARACTERISTICS:

WBC ≥ 3,000/mm^3
Platelet count ≥ 100,000/mm^3
Creatinine normal or creatinine clearance > 50 mL/min (unless renal dysfunction is due to tumor obstructing the ureters)
AST and ALT ≤ 3 times ULN
Bilirubin ≤ 2.0 times ULN
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No concurrent malignancy except for nonmelanoma skin cancer
No known HIV positivity
No active infections

PRIOR CONCURRENT THERAPY:

Recovered from prior surgery
More than 30 days since prior radiotherapy and recovered (unless evidence of progressive disease has been documented)
No prior chemotherapy
No other concurrent cytotoxic therapy
Concurrent radiotherapy and surgery allowed for treatment of brain metastases