Unique treatment strategy beneficial for metastatic testicular cancer
A study from IGP shows that carefully selected patients with metastatic testicular cancer benefit from early treatment with high doses of chemotherapy combined with stem cell transplantation.
Testicular cancer is the most common cancer among young men aged 15–35. This type of cancer is usually very sensitive to chemotherapy, and most patients can be cured.
However, if the disease has spread extensively, much more intensive chemotherapy is required. Since very high doses of chemotherapy also affect the body’s blood formation, a procedure called autologous stem cell transplantation can be performed at the same time. This involves removing the patient’s own blood stem cells before treatment and returning them to the patient after treatment to restore the bone marrow.
The method has been used in testicular cancer for some time, but it has been unclear which patients benefit most from it and when it should be administered. In the new study, researchers now show good results with early high-dose treatment with autologous stem cell transplantation according to a unique strategy from the Swedish-Norwegian testicular cancer group SWENOTECA.
“SWENOTECA has agreed on a common strategy, where tumour markers – substances in the blood that reflect how active the disease is – are used to determine which patients with widely spread testicular cancer should receive high-dose treatment. In our study, we showed that early high-dose treatment is also beneficial for those who respond with slowly decreasing tumour markers during the initial treatment,” says Anna Jansson, doctoral student at IGP and specialist in oncology at Uppsala University Hospital.
Improved long-term survival
The study included 80 testicular cancer patients who received high-dose treatment in Sweden and Norway. At the time of diagnosis, most of them already had extensive spread of the disease, with metastases in, for example, the brain, liver or skeleton. The results showed that patients who received early high-dose treatment due to slowly declining tumour markers had a five-year survival rate of 75 per cent. This is clearly better than what has been reported internationally for patients with a similarly poor prognosis.
“Since the 1980s, Sweden and Norway have worked closely together on the treatment of testicular cancer through SWENOTECA. Thanks to this, we now have one of the best survival rates in the world for testicular cancer. With the new study, we show that the strategy of early high-dose treatment in carefully selected high-risk patients appears to be beneficial and can lead to improved long-term survival,” says Ingrid Glimelius, professor at IGP and senior physician at the oncology clinic at Uppsala University Hospital, who led the study.
The study has been published in the scientific journal British Journal of Cancer.
Facts
- In Sweden, approximately 360 men are diagnosed with testicular cancer each year, and testicular cancer is the most common cancer among young men aged 15–35.
- The most common symptom of testicular cancer is a lump in the testicle.Treatment involves surgical removal of the affected testicle. If the disease has spread outside the testicle, it can usually be cured with the help of cytostatic drugs, and testicular cancer is now a form of cancer with a very good survival rate.
- The collaboration Swedish and Norwegian Testicular Cancer Group (SWENOTECA) has developed treatment guidelines and care programmes for testicular cancer.