New Drug Promising for Testicular Cancer

Single-dose carboplatin post-surgery just as effective as weeks of radiotherapy

THURSDAY, July 21, 2005 (HealthDay News) -- Following surgery, a single dose of the cancer drug carboplatin is just as effective, and less toxic, than the standard three weeks of radiation therapy traditionally used to fight stage 1 seminoma, a form of testicular cancer, British researchers report.

In addition, treatment with carboplatin results in the development of fewer new seminomas compared with traditional radiation therapy, according to the report in the July 23 issue of The Lancet.

For the past half-century, the standard care for seminoma has been to remove the cancerous testicle, usually followed by three weeks of radiotherapy. However, the researchers point to previous studies that found that patients followed for up to 30 years post-treatment still faced an increased risk of cancer in other organs, as well as heart disease.

Patients may finally have a new option, however. "We have defined a new standard for patients with testicular cancer," said lead author Dr. Tim Oliver, a professor of medical oncology at St. Bartholomew's and The London School of Medicine. "It's proven to be as safe as radiation, and it's less toxic."

In their study, Oliver and colleagues randomly assigned nearly 1,500 patients with stage 1 seminoma to a single course of post-surgery carboplatin or radiation therapy.

After three years of follow-up, they report that survival without relapse was similar in both groups -- 94.8 percent among those who received carboplatin compared with 95.9 percent among those who received radiation therapy.

In addition, Oliver's team found that five years after treatment, patients who had received carboplatin were less likely to develop tumors in the remaining testicle.

"We also found a very exciting effect," Oliver added. "For patients treated with carboplatin, there are 72 percent less tumors of the same sort in the other testis compared with radiation treatment," he said, meaning that "we may be able to reduce the necessity of taking the whole testicle."

The advantage of carboplatin treatment is that it is quick, effective and less toxic compared with radiation. "It means one day as an outpatient for a short drip in the arm," Oliver said. "You go home and sleep it off over the weekend and can be back to work after that, whereas with radiation you have to have three weeks of treatments."

Experts think the findings may turn carboplatin treatment into a viable new option for testicular cancer patients. "Traditionally, radiation has been used, and it's a long haul. And it has some major side effects," said Dr. Herman Kattlove, a medical oncologist and spokesman for the American Cancer Society. "A single dose of carboplatin is pretty easy. They give that to 80-year-olds," he added.

"If I were in practice I would definitely use this approach," Kattlove said.

The three-year study follow-up used to track the recurrence of seminoma is a little short, cautioned Dr. Philip Kantoff, a professor of oncology at Dana-Farber Cancer Institute. Still, "I don't think the results are subsequently going to change. Both chemotherapy with carboplatin and radiation are going to turn out to be equivalent," he said.

"To me this opens up the door to having another option available to patients," Kantoff added. "For some patients, observation is reasonable, for some patients radiation is a reasonable option, and for other patients giving carboplatin is a reasonable option."

More information

The American Cancer Society can tell you more about testicular cancer.

SOURCES: Tim Oliver, M.D., professor, medical oncology, St. Bartholomew's and The London School of Medicine, London, U.K.; Herman Kattlove, M.D., M.P.H., medical oncologist and spokesman, American Cancer Society, Atlanta, Georgia; Philip Kantoff, M.D., professor of oncology, Dana-Farber Cancer Institute, Boston, Mass.; July 23, 2005, The Lancet
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