Half the Amount of Chemo Prevents Testicular Cancer Recurrence

Testicular cancer can be prevented from coming back by using half the amount of chemotherapy that is currently used, according to a study published in European Urology.

Lowering overall exposure to chemotherapy may reduce debilitating side effects, which can have a lifelong impact on patients’ health.

To investigate whether giving men 1 cycle of chemotherapy was as effective at preventing testicular cancer recurrence as 2 cycles, Michael Cullen, MD, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom, and colleagues analysed 246 patients with vascular invasion-positive stage I non-seminoma germ cell tumours of the testis (NSGCTT) or combined seminoma and NSGCTT.

The patients were given 1 3-week cycle of bleomycin, etoposide, and cisplatin (BEP), and underwent regular imaging and tumour marker assessment for 5 years following treatment.

The researchers found that only 1.3% of men saw their testicular cancer return after finishing treatment -- a nearly identical rate to previous studies that used 2 cycles of BEP chemotherapy.

Of the men who received 1 cycle of BEP, 41% experienced ≥1 serious side effect while receiving treatment, such as an increased risk of infection, sepsis, or vomiting. However, only 2.6% of men experienced long-term side effects, such as damage to their hearing.

“Men with testicular cancer who are at high risk of recurrence have generally been treated with 2 cycles of chemotherapy, but our new study found that 1 cycle was enough to stop their tumour from coming back,” said Robert Huddart, PhD, The Institute of Cancer Research, London, United Kingdom. “Reducing the overall dose of chemotherapy could spare young men who have their whole lives ahead of them from long-term side effects, and also means they will need fewer hospital visits for their treatment.”

“This new trial is already changing clinical practice on a global scale, and is set to improve patients’ quality of life [in addition to] reducing the cost of testicular cancer treatment,” he concluded.

Reference: http://dx.doi.org/10.1016/j.eururo.2019.11.022

SOURCE: Institute of Cancer Research
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