(HealthDay News) — For high-risk stage 1 nonseminoma germ cell tumors of the testis (NSGCTT), 1 cycle of adjuvant bleomycin, etoposide (500 mg/m²), and cisplatin (BE500P) is safe, resulting in a 2-year malignant recurrence (MR) rate of 1.3%, similar to that reported for 2 cycles of BE360P, according to a study published online in European Urology.
Michael Cullen, MD, from the University Hospitals Birmingham NHS Foundation Trust in the United Kingdom, and colleagues compared recurrence rates for 1 cycle of BE500P to recurrence rates for 2 cycles of BE360P among 246 patients with vascular invasion-positive stage 1 NSGCTT or combined seminoma + NSGCTT registered in a single-arm prospective study.
Patients were followed for a median of 49 months. Ten patients with increasing tumor markers were excluded at baseline. The researchers found that 4 patients had MR at 6, 7, 13, and 27 months; all were treated with secondary chemotherapy, and at 5 years, 3 remained recurrence-free. The rate of 2-year MR was 1.3% (95% confidence interval, 0.3 to 3.7%). Nonmalignant recurrences developed in 3 patients who had localized differentiated teratoma; after surgery, they were rendered disease-free. In 6.8% of patients, grade 3 to 4 febrile neutropenia occurred.
“Our study has found strong evidence to suggest that testicular cancer chemotherapy can be safely reduced from 2 cycles to just 1 — making their treatment shorter, kinder, and cheaper,” a coauthor said in a statement.
Two authors disclosed financial ties to the pharmaceutical industry.
Cullena M, Huddart R, Joffe J. The 111 Study: A Single-arm, Phase 3 Trial Evaluating One Cycle of Bleomycin, Etoposide, and Cisplatin as Adjuvant Chemotherapy in High-risk, Stage 1 Nonseminomatous or Combined Germ Cell Tumours of the Testis. Eur Urol.