Treatment de-escalation for stage II seminoma

Wood, GE; Chamberlain, F; Tran, B; Conduit, C; Liow, E; Nicol, DL; Shamash, J; Alifrangis, C; Rajan, P

Author(s): Wood, GE; Chamberlain, F; Tran, B; Conduit, C; Liow, E; Nicol, DL; Shamash, J; Alifrangis, C; Rajan, P;
Details: Publication Year 2023-03-07,Volume 20,Issue #8,Page 502-512
Journal Title: Nature Reviews Urology
Abstract: International Germ Cell Cancer Collaborative Group good-risk metastatic seminoma has cure rates of >95%. Within this risk group, patients with stage II disease exhibit the best oncological outcomes with the standard-of-care treatment strategies of radiotherapy or combination chemotherapy. However, these treatments can be associated with substantial early and late toxic effects. Therapy de-escalation aims to reduce treatment morbidity whilst preserving oncological outcomes. The evidence supporting such approaches is largely from non-randomized institutional data, and therefore this strategy is not recognized as standard of care. Current de-escalation approaches for stage II seminoma include single-agent chemotherapy, radiotherapy and surgery based on early data from clinical studies. Increased recognition of emerging data on treatment modification to reduce morbidity whilst maintaining cure rates and consideration of therapy de-escalation could improve patient survivorship outcomes.
Publisher: NPG
Keywords: Male; Humans; *Seminoma/therapy; *Testicular Neoplasms/pathology; *Neoplasms, Germ Cell and Embryonal/pathology; Chemotherapy, Adjuvant; Risk Factors; Neoplasm Staging
Research Division(s): Personalised Oncology
PubMed ID: 36882564
Publisher's Version: https://doi.org/10.1038/s41585-023-00727-0
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-03-29 08:34:14

Last Modified: 2023-08-16 02:52:43