A study looking at a new chemotherapy plan for men with testicular cancer called seminoma that has spread (CarPET)

Cancer type:

Testicular cancer

Status:

Results

Phase:

Phase 2

This study looked at replacing BEP chemotherapy with high dose carboplatin to treat seminoma. It also looked at PET-CT scans to see if they can help to tell how well treatment works (response to treatment).

More about this trial

Seminoma is a type of testicular cancer that sometimes spreads to other parts of body such as the lungs. If this happens, you usually have a combination of chemotherapy drugs called BEP. This is made up of:

You usually have these drugs every 21 days. Each 21 day period is a cycle of treatment. You can have up to 4 cycles of treatment, staying in hospital for about a week each time. This is the standard treatment.

BEP chemotherapy has side effects. So doctors would like to reduce the side effects and the time it usually takes to give each treatment.

In this trial, doctors looked at a chemotherapy drug called carboplatin. They wanted to see if a higher dose of carboplatin works as well as the BEP chemotherapy combination.

Carboplatin has fewer side effects than BEP and you have it once, every 3 weeks. It takes about an hour each time you have it, so you spend less time in hospital.

The trial team also wanted to see if a PET-CT scan is better than a standard CT scan at telling how well the treatment works after 1 cycle of carboplatin (early response to treatment).

The main aims of this trial were to:

learn more about the safety and side effects of a high dose carboplatin
see how well a high dose of carboplatin works as a treatment for seminoma
see if a PET-CT scan can help to spot an early response to treatment, leading to fewer men needing 4 cycles of carboplatin

Summary of results

The trial team concluded that a high dose of carboplatin is an effective and safe treatment for men with seminoma. And that a PET-CT scan can tell how well the treatment works after 1 treatment cycle of carboplatin.

48 men with seminoma took part in this phase 2 trial. Everyone had treatment with high dose of carboplatin and a PET-CT scan:

before the start of treatment
after 1 treatment cycle of carboplatin

The trial doctors were able to look at the PET-CT scan results of 47 men. They found that in:

20 men the cancer disappeared after 1 cycle of treatment of carboplatin (metabolic response)
27 men the cancer got better after 1 cycle of treatment of carboplatin

Men who had a metabolic response after the 1st cycle of treatment, had a total of 3 treatment cycles of carboplatin. And men whose cancer got better (but had not disappeared) after the 1st treatment, had 4 cycles of treatment of carboplatin.

The research team looked at how well carboplatin worked. To do this they looked at the number of people whose cancer disappeared, got smaller or stayed the same after treatment. They found that:

32 out of 47 men’s cancer disappeared. This is a complete response
12 out of 47 men’s cancer got smaller. This is a partial response
3 out of 47 men’s cancer stayed the same. This is stable disease

The team also looked at the side effects of carboplatin. These were:

a drop in the number of blood cells causing an increased risk of infection and bleeding
tiredness (fatigue)
sickness
ringing in the ears (tinnitus)
problems with the nerves causing numbness and tingling

The trial team concluded that a high dose carboplatin is an effective treatment for men with seminoma. They also concluded that there weren’t many side effects, so the team thinks this is a safe treatment.

Doctors were able to use the PET-CT scan to find out how well the treatment was working. And were able to give less chemotherapy to men who showed a good response to treatment.

They think the results from this trial should be confirmed by doing a larger trial comparing carboplatin to the standard treatment.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) but may not have been published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.