Reduced chemotherapy effective in testicular cancer

Testicular cancer can be prevented from recurring using half the amount of chemotherapy that is currently used, a new clinical trial has shown.

The study published in European Urology (doi:10.1016/j.eururo.2019.11.022) and led by The Institute of Cancer Research and University Hospitals Birmingham NHS Foundation Trust, involved nearly 250 men with early-stage testicular cancer at high risk of recurrence. The patients were given one, three-week cycle of bleomycin, etoposide and cisplatin instead of the usual two cycles.

At two years only three men (1.3%) had a recurrence of their cancer, a nearly identical rate to previous studies using two cycles of chemotherapy.

In the new study, 41% of men receiving one cycle of chemotherapy experienced one or more serious side effects, such as an increased risk of infection, sepsis or vomiting. But only a small number – six patients, or 2.6% – experienced long-term side effects such as damage to their hearing. According to the study authors, these rates are substantially lower than those seen with two cycles of chemotherapy.

Robert Huddart, Professor of Urological Cancer at The Institute of Cancer Research, says: ‘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 will change clinical practice on a global scale, and improve patients’ quality of life as well as reducing the cost of testicular cancer treatment.’

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