IU Researchers Confirm Best Treatment For Long-Term Testicular Cancer Survival

INDIANAPOLIS-- Observing long term survival rates, researchers at Indiana University School of Medicine have reconfirmed the conclusions of a groundbreaking 10-year-old study which originally compared the effectiveness of two protocols for chemotherapy in the treatment of testicular cancer. The long-term follow-up study determined that survival rates for testicular cancer patients remained equal whether they received three or four cycles of chemotherapy.

The findings are reported in the February issue of the Journal of Clinical Oncology.

Researchers, lead by Scott Saxman, M.D., assistant professor of medicine at the IU School of Medicine, looked at the survival rates of men who had been enrolled in a testicular cancer study in the mid-1980s to see if the original conclusions held true a decade after their treatment. All the men in the follow-up study were originally treated at I.U.

"What we wanted to determine with the long-term follow up was the percentage of patients actually cured and whether three cycles of chemotherapy were as effective as four," said Dr. Saxman. "Ninety percent of patients remain alive and cancer free with an average follow-up of 10 years. There is no difference in survival between the patients who received three cycles of chemotherapy as compared to those who got four."

Data from the earlier study had shown that three cycles of a specific combination chemotherapy were just as effective and less toxic to patients with testicular cancer than the same combination therapy administered in four cycles. The study was conducted from October 1984 to June 1987. The original study determined that the fourth cycle of bleomycin, etoposide and cisplatin (BEP) could be deleted, significantly reducing cost, toxicity and patient inconvenience without sacrificing therapeutic efficacy or survival.

At the time of the original study, patients had a minimum follow-up of 12 months and a median follow-up of 19 months.

The BEP chemotherapy regimen was pioneered at the I.U. School of Medicine by oncologist Lawrence H. Einhorn, M.D., distinguished professor of medicine. That protocol, along with a surgical procedure also developed at I.U. by John Donahue, M.D., distinguished professor emeritus of urology, dramatically advanced the treatment outcome for patients with testicular cancer. Nearly 20 years after its development, BEP remains the standard therapy for testicular cancer. If caught in time and treated with BEP, testicular cancer is highly curable. Before BEP therapy was introduced, the cure rate in patients with advanced disease was less than 10 percent.

Testicular cancer accounts for only about 1 percent of all malignancies in males, but is the most common solid tumor occurring in men between the ages of 15 and 35.

The follow-up study was supported in part by the National Cancer Institute and the Walther Cancer Institute.

Most recently, testicular cancer made headlines when Olympians Scott Hamilton and Lance Armstrong were diagnosed and successfully treated for the disease.

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