Sunitinib Malate in Refractory Germ Cell Tumors

Inclusion Criteria:

1. Progressive metastatic GCTs of gonadal or extragonadal origin in males after failure of front-line therapy and at least one salvage regimen.
2. Must have evaluable or measurable disease by clinical or radiological studies. Alternatively, in the absence of radiologically evaluable or measurable disease, two sequentially rising marker values each one week apart attributed by treating physician to germ cell tumor is permitted; either beta HCG above 50 mIU/ml and/or AFP above 20 ng/ml qualifies as eligible.
3. ECOG Performance Score 0-2
4. Adequate organ function as follows: Calculated creatinine clearance >/= 35cc/min, Absolute neutrophil count >/= 1500/mm^3, hemoglobin >/= 8 g/dL, serum calcium </= 12 mg/dL, Platelet count >/= 75,000/mm^3, AST/ALT < 2.5 x ULN, Total bilirubin < 2.0mg/dl.
5. Resolution of all acute toxic effects of prior chemotherapy or radiotherapy or surgical procedures to NCI CTCAE Version 3.0 grade </= 2.
6. At least 18 years of age as safety of sunitinib in a pediatric population has not been established.
7. Able to provide informed consent
8. Must be able to ingest oral medication
9. Male subjects must be surgically sterile or must agree to use effective contraception during the period of therapy. The definition of effective contraception will be based on the judgment of the principal investigator or a designated associate.
10. Patients who have not received prior high-dose chemotherapy and stem cell rescue as salvage therapy will have this option discussed with them. Only patients ineligible, unwilling or unable to undertake this option will be eligible for this trial.

Exclusion Criteria:

1. NCI CTCAE Version 3.0 grade 3 hemorrhage within the 4 weeks prior to starting the study treatment.
2. Any of the following within the 12 months prior to study drug administration: myocardial infarction, severe/unstable angina, coronary/peripheral artery bypass graft, symptomatic congestive heart failure, cerebrovascular accident or transient ischemic attack, or pulmonary embolism.
3. Patients with history of Long QT syndrome.
4. Ongoing cardiac dysrhythmias of NCI CTCAE Version 3.0 grade >/= 2.
5. Uncontrolled Hypertension (> 140/90 mm Hg despite optimal medical therapy).
6. Pre-existing thyroid abnormality with thyroid function that cannot be maintained in the normal range with medication.
7. Symptomatic bowel obstruction.
8. Prior VEGFR/PDGFR inhibitor therapy.
9. Known human immunodeficiency virus infection, chronic active hepatitis or liver cirrhosis.