Novel Testicular Cancer Treatment Developed at Indiana University

By Zachary Osterman, Indiana Daily Student, July 30, 2007

According to a report in the New England Journal of Medicine, patients who do not respond to initial chemotherapy may be aided by a new treatment that has been discovered by researchers at IU’s School of Medicine.

116 of the 184 patients involved in the study went into complete remission after being treated said the report which was authored by several researchers, including renowned IU oncologist Dr. Lawrence Einhorn.

“Testicular tumors are potentially curable by means of high-dose chemotherapy plus hematopoietic stem-cell rescue, even when this regimen is used as a third-line or later therapy or in patients with platinum-refractory disease,” the report concluded.

Stephen Williams said this kind of research had been ongoing. However, the results in the report were obtained when several people brought their research together in one study said Williams, who is one of the co-authors of the report and the associate dean for cancer research at the School of Medicine.

“People have been doing high-dose chemotherapy ... for quite some time, but it had been awhile since we had compiled our results,” Williams said.

“I think the results even surprised us, how well they were doing. It’s fairly impressive.”

To fight the more drug-resistant malignancies discussed in the report, Williams said administering high doses of stronger than normal chemotherapy was necessary. The process of removing and freezing a patient’s stem cells from their blood happens prior to the chemotherapy of course so that the stem cell themselves are not damaged or destroyed completely.

The frozen stem cells are replaced to counteract that lowering effect that occurs when the drugs lower the patient’s blood cell count. The higher doses of chemotherapy could potentially be deadly to patients without the stem cell replacement.

Even after receiving chemotherapy this experimental method of treating patients with metastatic testicular cancer that had progressed proved effective in defeating the disease the report concluded.

According to webmd.com, the overall cure rate for testicular cancer is in the range of 90 percent. About 70 percent of patients still respond to treatment and are cured of the disease even after the malignancy has spread.

A small number of testicular cancer patient cases would apply to this particular treatment said Williams. High-dose chemotherapy is effective in “a little bit more than 60 percent” of those patients and only 5 to 10 percent of patients advance to the stage where this form of treatment would be necessary he added.

Williams called testicular cancer “the most curable adult-solid tumor.”

For those types of cancer that have been historically resistant to chemotherapy, this method of treatment may not be as effective said Williams. Testicular cancer is not in that category.

And because of required training for medical personnel, the treatment may be difficult to offer despite its effectiveness.

“It’s still a pretty big deal. It takes a sophisticated team of people to take care of these patients,” Williams said. “Our ability to take care of the patients ... has improved a lot over the years. We’ve just gotten better at it, I think, in a variety of ways."

Williams said that the findings in the report will only spawn further work and that researchers will always continue to look for new and innovative ways to battle all forms of cancer.

“We will continue to seek better forms of chemotherapy that can be given in high dosages,” Williams said.

Einhorn developed a method of successfully treating testicular cancer in the 1970s by mixing chemotherapy with a drug considered experimental at the time. He is a leader in testicular cancer research who helped cure seven-time Tour de France winner Lance Armstrong during his now-famous bout with the disease.

The New England Journal of Medicine has published the report in their July 26th issue.