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Chemotherapy, Stem Cells Beneficial in Testicular Cancer

Even as third-line therapy, high-dose chemotherapy plus stem cell rescue may cure metastatic germ cell testicular cancer

FRIDAY, July 27 (HealthDay News) -- Metastatic testicular germ cell tumors may be curable with high-dose chemotherapy plus hematopoietic stem cell rescue, according to a report in the July 26 issue of the New England Journal of Medicine.

Lawrence H. Einhorn, M.D., of the Indiana University Cancer Center in Indianapolis, and colleagues examined the efficacy of high-dose chemotherapy plus hematopoietic stem cell rescue in 184 patients with cisplatin-resistant, progressively growing testicular cancer.

Of these patients, 173 received two consecutive courses of high-dose chemotherapy for three days followed by an infusion of autologous peripheral-blood hematopoietic stem cells after each chemotherapy treatment. The other 11 patients received a single course of the treatment.

During a median follow-up of 48 months, 63 percent of the 184 patients were continually disease-free. Of these, 90 percent were disease-free for more than two years. Moreover, 18 of 40 patients with progressive metastatic disease and tumors that were refractory to platinum remained disease-free for a median of 49 months and 22 of 49 patients who received high-dose chemotherapy as third-line or later treatment remained disease-free for a median of 46 months. There were a total of three drug-related deaths occurring during therapy. Three patients developed acute leukemia after therapy.

"Testicular tumors are potentially curable by means of high-dose chemotherapy plus hematopoietic stem cell rescue, even when this regimen is used as third-line or later therapy or in patients with platinum-refractory disease," the researchers conclude.

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