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Advanced therapy offers cure for relapsed cancer patient
July 26, 2007INDIANAPOLIS -- Testicular cancer patients who do not respond to traditional therapy can be cured with high-dose chemotherapy and a stem cell transplant, according to an Indiana University School of Medicine report in the July 26 issue of the New England Journal of Medicine.
About 90 percent of testicular cancer patients respond to traditional therapy, which involves multiple courses of cisplatin, first used successfully in the treatment of this disease by Lawrence Einhorn, M.D., at Indiana University Cancer Center in the early 1980s. That course of therapy turned a disease from a mostly fatal cancer into one of the more curable forms of cancer for men, who typically are in their 20s when diagnosed with testicular cancer.
It is rare for the NEJM to carry a retrospective study from a single institution that is not a randomized study. This review looks at the outcome of 184 patients with metastatic testicular cancer. Dr. Einhorn and colleagues demonstrated that the disease is potentially curable with a high dose chemotherapy and stem cell transplant using cells harvested from the patient before the initial chemotherapy infusion.
The patients received carboplatin chemotherapy at five times the dosage administered to men receiving initial therapy. A side effect of the high dosage is a reduction of blood cells so a stem cell transplant is given to replenish the body's immune system through a process similar to a blood transfusion. Three to four weeks later the entire process is repeated.
"The message for patients is that through research, diligence and new technologies there is hope," said Dr. Einhorn, professor of medicine at the Indiana University Melvin and Bren Simon Cancer Center and the lead author of the study. "The bar is steadily being raised and more patients are being saved."
"This review confirms that high-dose chemotherapy combined with a stem cell transplant can provide a cure for a group of patients with relapsed testicular cancer," said Rafat Abonour, M.D., associate professor of medicine in the division of hematology/oncology and associate dean for clinical research at the IU School of Medicine.
Although the number of relapsed testicular cancer patients is small, the IU Simon Cancer Center treats a majority of them. As a leader in this treatment, the researchers were able to collect the necessary data for the NEJM retrospective.
For the patients each year who are treated with this therapy, there is renewed hope. "This is new medicine and it tells patients that cures are on the horizon," said Stephen D. Williams, M.D., director of the IU Simon Cancer Center and a co-author of the paper.
Indiana University
The patients received carboplatin chemotherapy at five times the dosage administered to men receiving initial therapy. A side effect of the high dosage is a reduction of blood cells so a stem cell transplant is given to replenish the body's immune system through a process similar to a blood transfusion. Three to four weeks later the entire process is repeated.
"The message for patients is that through research, diligence and new technologies there is hope," said Dr. Einhorn, professor of medicine at the Indiana University Melvin and Bren Simon Cancer Center and the lead author of the study. "The bar is steadily being raised and more patients are being saved."
"This review confirms that high-dose chemotherapy combined with a stem cell transplant can provide a cure for a group of patients with relapsed testicular cancer," said Rafat Abonour, M.D., associate professor of medicine in the division of hematology/oncology and associate dean for clinical research at the IU School of Medicine.
Although the number of relapsed testicular cancer patients is small, the IU Simon Cancer Center treats a majority of them. As a leader in this treatment, the researchers were able to collect the necessary data for the NEJM retrospective.
For the patients each year who are treated with this therapy, there is renewed hope. "This is new medicine and it tells patients that cures are on the horizon," said Stephen D. Williams, M.D., director of the IU Simon Cancer Center and a co-author of the paper.
Indiana University
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Drugs made using unusual metals could form an effective treatment against colon and ovarian cancer, including cancerous cells that have developed immunity to other drugs, according to research at the University of Warwick and the University of Leeds.
Second gene linked to familial testicular cancer
Specific variations or mutations in a particular can gene raise a man's risk of familial, or inherited, testicular germ-cell cancer, the most common form of this disease.
Hypospadias, a birth defect of the male urethra, is not increasing in New York state
In recent decades, there have been periodic reports of a worldwide decline in sperm count and quality.
Penn researchers discover genetic risk factor for testicular cancer
Researchers at the University of Pennsylvania School of Medicine have uncovered variation around two genes that are associated with an increased risk of testicular cancer.
Women 10 times more likely to do breast self-exams correctly with intervention, KP study finds
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GUMC Researchers Show Adult Human Testes Cells Can Become Embryonic Stem-like, Capable of Treating Disease
Using what they say is a relatively simple method, scientists at Georgetown University Medical Center have extracted stem/progenitor cells from adult testes and have converted them back into pluripotent embryonic-like stem cells. Researchers say that the naïve cells are now potentially capable of morphing into any cell type that a body needs, from brain neurons to pancreatic tissue.
Marijuana use linked to increased risk of testicular cancer
Frequent and/or long-term marijuana use may significantly increase a man's risk of developing the most aggressive type of testicular cancer, according to a study by researchers at Fred Hutchinson Cancer Research Center. The study results were published online Feb. 9 in the journal Cancer.
UNC study supports role of circadian clock in response to chemotherapy
For years, research has hinted that the time of day that cancer patients receive chemotherapy can impact their chances of survival. But the lack of a clear scientific explanation for this finding has kept clinicians from considering timing as a factor in treatment.
Low sperm count may be associated with prenatal testosterone excess
Exposure to an excess of sexual steroids, like testosterone, during fetal development may be a potential risk factor for low sperm count and motility.
Maternal exposure to persistent organic pollutants linked to urologic conditions in boys
Higher incidences of congenital anomalies, including cryptorchidism (undescended testicles) and hypospadias, were found in boys whose mothers had higher serum levels of certain organochlorine compounds, researchers say.
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