A trial looking at chemotherapy for male germ cell cancer (TE 23)

Cancer type:

Testicular cancer

Status:

Results

Phase:

Phase 2

This trial compared 2 different chemotherapy treatments for male germ cell cancers. This trial was supported by Cancer Research UK.

Germ cells are the cells that produce eggs in females and sperm in males. Male germ cell cancers usually develop in the testicles, but can be found in other parts of the body.

Doctors usually treat germ cell cancers with surgery if it is in the testicle, and also with chemotherapy if it is somewhere else in the body. They usually give a combination of chemotherapy called BEP.

BEP doesn’t always work well for germ cell cancers that are classed as having a ‘poor outlook’ (prognosis Open a glossary item ). A poor outlook means that your cancer has spread to particular parts of your body or that your cancer started in your chest (mediastinum ). Doctors thought a new combination of drugs known as CBOP BEP may have worked better for these cancers. CBOP BEP is carboplatin and vincristine with the drugs used in BEP. But all chemotherapy drugs have some side effects, and it is important that patients don’t have treatments they don’t need.

The aims of this trial were to compare BEP with CBOP BEP to see which may cause the cancer to shrink more for poor prognosis male germ cell cancer and to find out more about the side effects.

Summary of results

The trial team found that CBOP BEP may be better than BEP for men with germ cell cancer who had a poor outlook (prognosis).

This was a randomised trial. The 89 men who took part were put into 1 of 2 groups.

46 men had BEP
43 men had CBOP BEP

The researchers looked at the number of men in each group who responded well to the chemotherapy. This was the number of men who had no sign of cancer (a complete response Open a glossary item ) added to the number of men whose cancer had shrunk (a partial response ) and who had normal results of blood tests for testicular cancer markers. They found that

28 men who had BEP had a favourable response
32 men who had CBOP BEP had a favourable response

A year after treatment the researchers looked at the number of men who were alive and free of cancer. They found that

20 men who had BEP were
28 men who had CBOP BEP were

2 years after treatment 55 men were known to still be alive

27 men had BEP
28 men had CBOP BEP

The most common side effects of BEP and CBOP BEP were

A drop in blood cells causing an increased risk of infection, bruising and bleeding
Feeling or being sick
Tiredness (fatigue)

These side effects tended to be more frequent with CBOP BEP.

The trial team concluded that CBOP BEP may be better at shrinking germ cell cancer, but a larger international trial is needed to find out how well it works to prevent cancer coming back.

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