Research in testicular cancer

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We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better ways to treat testicular cancer. The following is a selection of research showing promise for treating testicular cancer.

We've included information from the following sources. Each item has an identity number that links to a brief overview (sometimes called an abstract).

  • PubMed, US National Library of Medicine (PMID)

  • Canadian Cancer Trials and ClinicalTrials.gov (NCT)

Active surveillance

Active surveillance for testicular cancer means that your healthcare team watches closely to see if the cancer comes back (recurs) after surgery rather than giving other treatments right away. They use tests and exams to see if testicular cancer is returning. Treatment is given only when the cancer has come back. This approach helps avoid side effects that can happen with treatments. Researchers studied active surveillance as a treatment option for people with clinical stage 1 germ cell testicular cancer following a radical inguinal orchiectomy. They found that people who received active surveillance had similar outcomes as people who received other treatments after surgery, such as chemotherapy, radiation therapy or lymph node removal (Journal of Clinical Oncology, PMID 25135991; Clinical and Translational Oncology, PMID 30470992).

Surgery

Researchers are looking for the best ways to treat testicular cancer using surgery and improve how surgery is done.

Testicle-sparing surgery (TSS) tries to spare most of a testicle. It may be an alternative to the standard treatment for some cases of testicular cancer. Standard treatment currently involves removing the testicle with cancer. For people who have cancer in both testicles or in the one remaining testicle, having the standard treatment would mean that they could no longer father children. Researchers are studying testicle-sparing surgery as a possible treatment to prevent infertility (International Urology and Nephrology, PMID 31267441; The Urologic Clinics of North America, PMID 31277728).

Robot-assisted retroperitoneal lymph node dissection (RPLND) is a newer procedure that allows the surgeon to use a computer to move surgical instruments connected to robotic arms. The operation is done through several small surgical cuts (incisions), much like laparoscopic surgery. Some surgeons are studying robot-assisted RPLND to remove lymph nodes in people with testicular cancer. Both laparoscopic and robot-assisted RPLND are linked with shorter hospital stays and fewer side effects compared to open RPLND, but it is currently unclear whether the results are as good as with open RPLND. More and better studies are needed to confirm this technique's potential role in staging and treating testicular cancer (Journal of Urology, PMID 32717162; Translational Andrology and Urology, PMID 32055487).

Immunotherapy

Immunotherapy helps strengthen or restore the immune system's ability to find and destroy cancer cells. This works to kill cancer cells and stop cancer cells from growing and spreading. Researchers are looking at immunotherapy drugs to see if they might be helpful in treating testicular cancer.

Monoclonal antibodies are both an immunotherapy and a targeted therapy. They bind to specific antigens on cancer cells to help destroy them. Researchers are studying brentuximab vedotin (Adcetris) in clinical trials to see if it can be used to treat testicular cancer that expresses CD30 (Investigational New Drugs, PMID 30993587).

Molecular profiling

Molecular profiling is a type of testing that looks at the unique features of the genes in cancer cells, as well as any related biomarkers. Researchers hope that molecular profiling will help doctors predict a prognosis and find the best treatments for certain cancers. Molecular profiling may also help doctors create targeted therapies for each cancer based on the specific genetic makeup of the tumour. Most testicular germ cell tumours respond to chemotherapy but about 10% do not (Nature Communications, PMID 32366847). Seminoma and non-seminoma germ cell tumours have high amounts of certain small non-coding RNAs (called micro-RNAs). Among these micro-RNAs, miR371a-3p (miR371) often predicts germ cell tumours in people with early and advanced testicular cancer (Journal of Clinical Oncology, PMID 31553692, PMID 30875280). A large clinical trial across Canada and the US is currently recruiting patients to confirm miR371's accuracy in detecting early-stage germ cell testicular tumours (ClinicalTrials.gov, NCT04435756).

Learn more about cancer research

Researchers continue to try to find out more about cancer. Clinical trials are research studies that test new ways to treat cancer. They also look at ways to prevent, find and manage cancer.

Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for cancer were first shown to be effective through clinical trials.

Find out more about clinical trials.

Expert review and references

  • Christian Kollmannsberger, MD, FRCPC