UNIVERSITY HOSPITAL OF BASEL: Carboplatin chemotherapy and node radiotherapy in testicular cancer
Year of Grant: 2013
Testicular cancers are the most common malignancies in men aged between 18-35 years. Of those, seminoma is the most frequent as it accounts for about half of all testicular cancers. Around 10% of all seminoma patients are diagnosed with stage IIA/B disease. Stage IIA patients have one or more enlarged regional lymph nodes, 2 cm or less in greatest dimension, without evidence of distant disease. Stage IIB patients have one or more enlarged regional lymph nodes more than 2 cm but not more than 5 cm in greatest dimension, without evidence of distant disease.
Seminoma stage IIA/B is highly responsive to chemotherapy or radiation therapy and the progression free survival at 5 or 6 years with such treatments is between 87-95%. Supra-diaphragmatic lymph nodes are the usual site of tumor recurrence after radiation therapy, while local failure or tumor persistence in paraaortic lymph nodes is predominant after chemotherapy.
Current standard of therapy in patients with stage IIA/B seminoma involves either large volume radiation therapy or chemotherapy with BEP (Bleomycin, Etoposide, Cisplatin). While both treatment modalities offer good cure
rates, they also bear the risk of unwanted events during and following the treatment.
Both therapy modalities may also lead to secondary tumors, which are especially relevant for the patient group: men aged between 18-35 years, in the prime of life, starting and building up their working life. Therefore the current research on seminoma focuses on minimizing short and long term treatment-related morbidity.
The main objective of this multi-center, single arm trial, in which both stage IIA and IIB patients are included is to test the efficacy and safety of carboplatin chemotherapy and involved node radiotherapy in patients with stage IIA/B seminoma.
If the proposed therapy scheme proves to be effective and safe, it will provide a significantly relevant treatment alternative to large volume radiotherapy and intense chemotherapy, and may become the new standard of care for patients with seminoma stage IIA/B.