Testicular cancer patients who do not respond to traditional therapy can be cured with high-dose chemotherapy and a stem cell transplant using cells harvested from the patient before the initial chemotherapy infusion, suggests a retrospective review by researchers from Indiana University School of Medicine, Indianapolis.
Lawrence Einhorn, MD, and colleagues studied 184 patients (median age, 31 years) with metastatic testicular cancer. The patients received chemotherapy with carboplatin (Paraplatin) 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. Three to 4 weeks later, the entire process is repeated.
Complete remissions after a median of 48 months follow-up were reported in 94 of 135 men administered the regimen as second-line therapy and 22 of 49 who received it as third-line or later therapy, as reported in the New England Journal of Medicine (2007; 357:340-8). Three treatment-related deaths occurred in the 184-patient study population.
"The message for patients is that through research, diligence, and new technologies, there is hope," Dr. Einhorn said. "The bar is steadily being raised and more patients are being saved."