Halving chemotherapy can still prevent testicular cancer return, trial concludes

Men with testicular cancer could be spared some of the side effects of chemotherapy after new research suggested their treatment could be halved.

A new clinical trial concluded the cancer can be prevented from coming back using half the amount of chemotherapy that is currently used.

In many men who have had surgery for an aggressive form of the disease, it can return within two years after initial diagnosis elsewhere in their bodies, needing intensive treatment.

The new trial found one cycle of chemotherapy was as effective at preventing testicular cancer from coming back as the standard two cycles.

Scientists say lowering the overall exposure to chemotherapy reduces the debilitating side effects which can have a lifelong impact on patients’ health.

The 111 trial was led by the Institute of Cancer Research, London (ICR) and University Hospitals Birmingham NHS Foundation Trust, and involved nearly 250 men with early stage testicular cancer at high risk of the disease returning after surgery.

The research, published in the journal European Urology, was funded by Cancer Research UK and the Queen Elizabeth Hospital Birmingham Charity.

Testicular cancer is the most common cancer affecting young men, with many patients diagnosed in their 20s or 30s.

After surgery, patients are currently offered two cycles of chemotherapy, or a watch-and-wait approach – where they receive no treatment unless their cancer comes back, at which point they are given three cycles.

In the new study, patients were given one three-week cycle of a chemotherapy known as BEP – a combination of the drugs bleomycin, etoposide and the platinum agent cisplatin.

Researchers found three men – 1.3% – saw their testicular cancer return after finishing treatment – a nearly identical rate to previous studies using two cycles of BEP chemotherapy.

In the new study, 41% of men receiving one cycle of chemotherapy experienced one or more serious side effect while receiving treatment, such as an increased risk of infection, sepsis or vomiting.

But only six patients, or 2.6%, experienced long-term side effects such as damage to their hearing.

Robert Huddart, professor of urological cancer at the ICR, and consultant in urological oncology at the Royal Marsden NHS Foundation Trust, said: “Men with testicular cancer who are at high risk of recurrence have generally been treated with two cycles of chemotherapy – but our new study found that one cycle was enough to stop their tumour from coming back.

“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 as well as reducing the cost of testicular cancer treatment.

“Reducing the number of cycles and the dosage of chemotherapy for testicular cancer could save the NHS money, and free up valuable hospital time and resources.”