Prognostic factors for patients with advanced seminoma treated with platinum based chemotherapy
Is it possible to identify what makes men respond differently to treatment for a particular type of testis cancer?
What was this study about?
Not all patients with a particular type of cancer will respond in the same way to the same treatment. Prognostic factors are things that help doctors decide which people are more or less likely to respond to standard treatment. They might include things like age and general health, as well as things specific to the type of cancer, such as the size and location of the tumour. This study aimed to identify the most reliable prognostic factors for men with a type of testes cancer called a seminoma. It is most common in men aged between 30 and 50. Until the mid 1980’s, doctors usually treated men with seminoma which had spread beyond the testis (advanced disease) with radiotherapy. But after this time doctors increasingly began to treat this group of men with chemotherapy, using a drug called cisplatin. Researchers wanted to work out how best to identify men who might respond best to smaller doses of chemotherapy, and who might need higher doses. A smaller dose of chemotherapy often means there are fewer unwanted side effects.
What difference did this study make?
Researchers identified several factors that could help doctors understand how men with advanced seminoma might respond to standard treatment. Using these factors they could divide men into two groups – a large group who did well on standard treatment and a small group who did not, and might therefore benefit from a different type of chemotherapy.
They used these factors to develop a simple and practical guide that would help doctors and patients to understand more about their condition.
Men with advanced seminoma are quite uncommon. Therefore the data used in this study was combined with data from many other similar patients around the world in a project called the International Germ Cell Consensus Classification. This is now used to guide the type of chemotherapy that men with advanced seminoma receive.
Type of study
Who funded the study?
The Medical Research Council.
When did it take place?
Information was collected about men who were treated between 1988 and 1992. The results of this study were published in 1997.
Who was included?
This study gathered together information on 286 men with advanced seminoma who had received chemotherapy including the drug cisplatin as part of their normal treatment. It also included information which had already been collected about 137 men who had taken part in two clinical trials looking at different types of chemotherapy for men with advanced seminoma – TE12 and EORTC 30874.