High-dose chemotherapy improves outcomes for multiply relapsed and refractory germ-cell tumors
MD Anderson Research News September 02, 2025
Testicular cancer is the most common malignancy in young men ages 15 to 35. Most patients respond well to cisplatin-based chemotherapy, with cure rates for metastatic disease as high as 70-80%, but some patients have tumors that relapse. High-dose chemotherapy (HDC) can be effective for some patients after an initial relapse, but outcomes are poor for those with multiple relapses or refractory tumors. In a Phase II trial, researchers led by Yago Nieto, M.D., Ph.D., examined the safety and efficacy of a new HDC specifically targeting DNA damage repair in combination with the targeted therapy bevacizumab. The trial enrolled 65 patients with multiply relapsed and heavily pretreated testicular and other germ-cell tumors. The five-year relapse-free and overall survival rates were 54% and 55.5%, respectively, exceeding expectations. However, the addition of bevacizumab did not improve outcomes. These results were subsequently validated in a prospective cohort of 100 patients with similar poor prognosis, highlighting the promising impact of targeting DNA damage repair pathways to improve outcomes for these patients. Learn more in Clinical Cancer Research.
This trial was the result of a large multidisciplinary effort in patients with refractory germ-cell tumors, who clearly need more active high-dose chemotherapy than the regimens that have been in use for the past 30 years. Our results were very encouraging for this population of patients who typically have a very unfavorable prognosis.