Leah Lawrence

GU Oncology Now

Progression-free survival for stage IIA and stage IIB seminoma was improved with the use of single-dose carboplatin and involved-node radiotherapy, but failed to meet the primary endpoint set out in a phase-2 trial of the treatment strategy.&ldquo;Standard treatment options for patients with stage IIA or stage IIB seminoma include either para-aortic and pelvic radiotherapy, or 3 to 4 cycles of cisplatin-based combination chemotherapy,&rdquo; researchers wrote in Lancet Oncology. &ldquo;These options result in 3-year progression free survival rates of at least 90%, but bear risks for acute and late toxic effects, including secondary malignancies.&rdquo;The phase-2 trial was designed to test de-escalated chemotherapy and de-escalated involved node radiotherapy in an attempt to reduce toxicity.The trial included 116 patients with stage IIA or IIB classic seminoma. The patients were treated with 1 cycle of carboplatin followed by involved-node radiotherapy of 30 Gy in 15 fractions (for stage IIA) or 36 Gy in 18 fractions (for stage IIB). The median age of patients was 40.After a median of 4.5 years, the 3-year progression-free survival was 93.7%. Out of the patient test group, 7 had disease relapse and 1 patient died. However, the target progression-free survival was 95% at 3 years, thus the trial failed to meet its primary endpoint. Median progression-free survival was not yet reached.Seminoma-specific survival at the time of the analysis was 100%. The patient death that occurred was due to a second primary cancer diagnosed after the trial began.&ldquo;The acute toxicity profile in our trial differs from standard-of-care radiotherapy and cisplatin-based combination chemotherapy, which commonly lead to substantial acute toxic effects in around 50% of patients,&rdquo; the researchers wrote.Acute treatment-related adverse events of any grade were observed in 48% of patients. Grade 3 or 4 adverse events included neutropenia (4%), thrombocytopenia (3%), and vomiting (1%). No treatment-related deaths or late treatment-related adverse events were reported. Serious adverse events were seen in 5 patients (4%).&ldquo;Sceptics might point to data showing testicular germ cell tumor survivors receiving combined modality treatment are at the highest risk for secondary malignancies compared with those receiving only single-modality treatment,&rdquo; the researchers wrote. &ldquo;However, these data concerned patients who received full-dose radiotherapy and full-dose chemotherapy due to disease recurrence after 1 of the 2 modalities.&rdquo;Instead, based on these results, the researchers concluded that &ldquo;de-escalated combined modality treatment warrants further study in this setting.&rdquo;&nbsp;Reference<a href="https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(22)00564-2/fulltext" target="_blank" rel="noopener">Single-Dose Carboplatin Followed by Involved-Node Radiotherapy for Stage IIA and Stage IIB Seminoma (SAKK 01/10): A Single-Arm, Multicentre, Phase 2 Trial</a>

De-Escalated Combo Treatment for Seminoma Warrants Further Research

Testicular, Penile, and Rare Malignancies

Progression-free survival for stage IIA and stage IIB seminoma was improved with the use of single-dose carboplatin and involved-node radiotherapy.

De-Escalated Seminoma Combo Treatment Needs Further Research

About Us

Contributors and Partners

Editorial Policy

Advertising

eNewsletters

Calendar

Contact Us

Contribute

MashupMD

Cancer Nursing Today

Urban Health Today

Blood Cancers Today

DocWire News

Knowledge Hubs

Conference Coverage

Roundtables

The Uromigos

Uromigos Live 2024

AUC3

Localized

mHSPC/mCSPC

CRPC

Diagnostics

Prostate Cancer

Localized Renal Cell Carcinoma

Advanced Renal Cell Carcinoma

nccRCC

Renal Cell Carcinoma

Non-Muscle Invasive Urothelial Carcinoma

Muscle Invasive Urothelial Carcinoma

Advanced Urothelial Carcinoma

Upper Tract Urothelial Carcinoma

Urothelial Carcinoma

Testicular, Penile, and Rare Cancers

Video Insights

Advancements in Oncology

The Oncology Brothers

Expert Interviews

Journal

Subscribe