Test can predict relapse risk

Researchers have developed a test to identify the risk of testicular cancer relapse in patients, potentially sparing people from chemotherapy and its side effects if they do not need to go through it.

The vast majority of patients are at low-risk for having a relapse, which researchers said motivates them not to put them through unnecessary and potentially detrimental cancer treatment.

"Chemotherapy is extremely effective in treating testicular cancer, but it can have long-term consequences for a patient's health and well-being," said Janet Shipley, a professor of cancer molecular pathology at The Institute of Cancer Researcher, in a press release. "Patients deemed at low risk of relapse could simply be monitored and potentially could avoid chemotherapy. Approaches such as this to minimize chemotherapy are particularly important for cancers like testicular cancer, which affect young adults who could live with the side-effects for decades."

The researchers analyzed 177 tumor samples from patients with stage I non-seminomatous tumours who participated in the Medical Research Council Clinical Trials Unit. They found that three features of tumors could help predict the chance of relapse: levels of the molecule CXCL12; percentage of the tumor with an appearance of cancer stem cells; and whether or not blood vessels were present in the tumor.

Based on these three features, researchers determined that 94.3 percent of patients are in the low-risk group based on being relapse free for two years, 65.9 percent were in the moderate-risk group, and 30 percent were in the relapse-free high-risk group.

The results of the analysis were confirmed with another group of 80 patients in the Royal Marsden NHS Foundation Trust.

"Patients with stage 1 non-seminomatous germ cell tumors have to make a difficult choice of whether to be watched or to receive chemotherapy to reduce the risk of relapse," said Robert Huddard, a professor of urological cancer at the Institute of Cancer Research. "Our study may help men make this decision as among the three groups of patients identified we have found one with a very low risk of relapse where surveillance would seem to be best choice and a small group of men who have a very high risk of relapse who could be targeted with chemotherapy. We now need to test this prognostic index in larger groups of men in the clinic."
Source: UPI