New test to predict relapse of testicular cancers

October 15, 2015

Scientists have developed a new test to identify patients who are at risk of suffering a relapse from testicular cancer.

Assessing just three features of a common kind of testicular cancer - called non-seminomatous germ cell tumour - can identify those at most at risk of relapse even where there is no evidence of tumour spread.

The researchers believe the test could be used in the clinic to make decisions about which patients should be given chemotherapy.

Scientists at The Institute of Cancer Research, London, analysed 177 tumour samples from patients with stage I non-seminomatous tumours enrolled in clinical trials through the Medical Research Council (MRC) Clinical Trials Unit.

The work was funded by the MRC with support from the National Cancer Research Institute Testis Cancer Clinical Studies Group, and is published in Clinical Cancer Research.

Scientists at The Institute of Cancer Research (ICR) found that three different features of the tumours were important indicators of relapse risk: the levels of a molecule called CXCL12, the percentage of the tumour with an appearance of cancer stem cells and whether or not blood vessels were present in the tumour.

They scored tumours based on these features, and found that combining scores could divide patients up into three different risk groups based on how likely patients were to suffer a relapse of the disease within two years. It is rare for a patient to relapse from testicular cancer beyond this time.

They found that the vast majority of patients were in the low-risk group - where 94.3 per cent of patients were relapse free for two years. In the moderate-risk group 65.9 per cent of patients were relapse free. Strikingly, only 30 per cent of patients were relapse free in the high-risk group.

The researchers were able to validate the test in an additional group of 80 patients at The Royal Marsden NHS Foundation Trust.

Testicular germ cell tumours are the most common solid malignant tumour in young Caucasian men. Patients diagnosed with early-stage disease face a choice between monitoring with treatment if relapse does occur or upfront chemotherapy with its associated long-term side-effects. Predicting who does or does not need chemotherapy up front is therefore important to minimise treatment in this largely curable disease.

Study leader Professor Janet Shipley, Professor of Cancer Molecular Pathology at The Institute of Cancer Research, London, said:

"Our research has led to the development of a test that can detect patients that will benefit from treatment up front and spare those who are at lower risk from the side-effects of chemotherapy.

"Chemotherapy is extremely effective in treating testicular cancer, but it can have long-term consequences for a patient's health and wellbeing. Patients deemed at low risk of relapse could simply be monitored and potentially could avoid chemotherapy. Approaches such as this to minimise chemotherapy are particularly important for cancers like testicular cancer, which affect young adults who could live with the side-effects for decades."

Professor Robert Huddart, Professor of Urological Cancer at The Institute of Cancer Research, London, and Consultant at The Royal Marsden NHS Foundation Trust, said:

"Patients with stage 1 non-seminomatous germ cell tumours have to make a difficult choice of whether to be watched or to receive chemotherapy to reduce the risk of relapse. Our study may help men make this decision as among the three groups of patients identified we have found one with a very low risk of relapse where surveillance would seem to be best choice and a small group of men who have a very high risk of relapse who could be targeted with chemotherapy. We now need to test this prognostic index in larger groups of men in the clinic."
-end-


Institute of Cancer Research

Related Chemotherapy Articles from Brightsurf:

Chemotherapy is used to treat less than 25% of people with localized sarcoma
UCLA researchers have found that chemotherapy is not commonly used when treating adults with localized sarcoma, a rare type of cancer of the soft tissues or bone.

Starved cancer cells became more sensitive to chemotherapy
By preventing sugar uptake, researchers succeeded in increasing the cancer cells' sensitivity to chemotherapeutic treatment.

Vitamin D could help mitigate chemotherapy side effects
New findings by University of South Australia researchers reveal that Vitamin D could potentially mitigate chemotherapy-induced gastrointestinal mucositis and provide relief to cancer patients.

Less chemotherapy may have more benefit in rectal cancer
GI Cancers Symposium: Colorado study of 48 patients with locally advanced rectal cancer receiving neoadjuvant chemotherapy, found that patients receiving lower-than-recommended doses in fact saw their tumors shrink more than patients receiving the full dose.

Male fertility after chemotherapy: New questions raised
Professor Delb├Ęs, who specializes in reproductive toxicology, conducted a pilot study in collaboration with oncologists and fertility specialists from the McGill University Health Centre (MUHC) on a cohort of 13 patients, all survivors of pediatric leukemia and lymphoma.

'Combo' nanoplatforms for chemotherapy
In a paper to be published in the forthcoming issue in NANO, researchers from Harbin Institute of Technology, China have systematically discussed the recent progresses, current challenges and future perspectives of smart graphene-based nanoplatforms for synergistic tumor therapy and bio-imaging.

Nanotechnology improves chemotherapy delivery
Michigan State University scientists have invented a new way to monitor chemotherapy concentrations, which is more effective in keeping patients' treatments within the crucial therapeutic window.

Novel anti-cancer nanomedicine for efficient chemotherapy
Researchers have developed a new anti-cancer nanomedicine for targeted cancer chemotherapy.

Ending needless chemotherapy for breast cancer
A diagnostic test developed at The University of Queensland might soon determine if a breast cancer patient requires chemotherapy or would receive no benefit from this gruelling treatment.

A homing beacon for chemotherapy drugs
Killing tumor cells while sparing their normal counterparts is a central challenge of cancer chemotherapy.

Read More: Chemotherapy News and Chemotherapy Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.