A New Test To Identify The Need Of Chemotherapy In Testicular Cancer

A New Test To Identify The Need Of Chemotherapy In Testicular Cancer

Testicular cancer refers to malignancy of testicular cells. According to latest statistics, 1 in 263 men in US are likely to develop this malignancy at some point in their life. Usually men at 33 and above are more at risk of developing this malignancy, but the treatment offered in US, minimizes the risk of death as a result of testicular cancer by 1 in 5,000 cases.

A newreport published in the Clinical Cancer Research suggested that scientists have recently came up with a test that can be used for the identification of patients who have a potential risk of relapsing from testicular cancer.

Scientists speculate that the assessment of only 3 characteristics of a common type of testicular cancer (called seminomatous germ cell tumor), they can successfully distinguish those who have high risk of relapse, without any significant presence of the spread of tumor.

Caucasian young men are more likely to fall victim to a solid malignant testicular tumor often acknowledged as testicular germ cell tumor. Patients of the disease who have been diagnosed early have two options in case of relapse of tumor:

• A combination of treatment and regular monitoring
• Chemotherapy with added long lasting adverse effects

It is crucial to distinguish patients on the basis of necessity for chemotherapy as it can assist in the reduction of treatment procedures and unwanted added side effects. The newly devised test can help pinpoint the patients in a clinical setup, who need chemotherapy the most.

The research was based on the 177 samples of tumor collected from patients who had stage 1 non-seminomatous tumors and were listed in the MRC (Medical Research Council) Clinical Trial Unit.

The three different characteristics that were markers for risk of relapse included:

• CXCL12 levels
• Percentage of tumor that looked like cancer stem cells
• Whether the tumor contained blood vessels or not

The tumor was scored on the basis of above three features. With the addition of score for each aspect, the scientists categorized the patients into 3 different categories on the basis of outlook of the disease relapse within the span of 2 years, as patients of testicular cancer rarely relapse after this period.

Results

Low-risk group: The results revealed that majority of the patients were found to have low risk i.e. 94.3% showed no relapse within the period of 2 years.

Moderate-risk group: In this group 65.9% of the patients showed no relapse.

High-risk group: In this group 30% of the patients showed no relapse.

The validation of test took place on an additional 80 participants at The Royal Marsden Hospital, UK. The leading author Prof. Janet Shipley elaborated on how the test makes the detection easier for patients who necessarily need chemotherapy. Despite it being helpful in the treatment of testicular cancer, the long-term adverse effects of chemotherapy include emotional and fertility disorders, neuropathies, Reynaud’s syndrome, second malignancies and cardiovascular disease. Young adults exposed to chemotherapy can remain affected for decades and on long run things only gets worse.

Due to this new advancement, patients with low risk can simply be offered monitoring and treatment without involving any risk of side effects associated with chemotherapy.

References

• Fizazi, K., Pagliaro, L., Laplanche, A., Fléchon, A., Mardiak, J., Geoffrois, L., … & Theodore, C. (2014). Personalised chemotherapy based on tumour marker decline in poor prognosis germ-cell tumours (GETUG 13): a phase 3, multicentre, randomised trial. The Lancet Oncology, 15(13), 1442-1450.