Overview of Testicular Cancer Treatment
Testicular cancer is highly curable with cisplatin-based chemotherapy. BEP (bleomycin, etoposide, cisplatin) is the standard first-line regimen for advanced disease. EP (etoposide, cisplatin) is used for good-risk patients who cannot receive bleomycin. Salvage therapy with high-dose chemotherapy and autologous stem cell transplant can cure relapsed disease.
Treatment by Risk
Good-Risk Metastatic
- BEP × 3 cycles or EP × 4 cycles
Intermediate/Poor-Risk
- BEP × 4 cycles
Salvage
- TIP (paclitaxel, ifosfamide, cisplatin)
- High-dose chemotherapy + autologous SCT
Epidemiology & Impact
Testicular cancer is the most common solid tumor in men aged 15-35 with approximately 9,760 new cases and 500 deaths in 2025. One of the most curable cancers with 5-year survival exceeding 95%. Two main types: seminomas (55%) and nonseminomas (45%). Incidence rising 1% annually. Risk factors include cryptorchidism, family history, and prior testicular cancer.
Molecular Biology & Biomarkers
Isochromosome 12p is the molecular hallmark (80% of cases). KIT mutations occur in some seminomas. Serum markers AFP, hCG, and LDH are essential for diagnosis, staging, and monitoring. AFP indicates nonseminomatous elements, hCG can be elevated in both types.
Evolving Treatment Landscape
Stage I is managed with orchiectomy plus surveillance or adjuvant therapy. Metastatic disease receives BEP chemotherapy, curing approximately 80% with good-risk disease. Even multiply relapsed disease can be cured with high-dose chemotherapy and transplant. Testicular cancer is the paradigm for chemotherapy cure of metastatic solid tumors.
Approved Testicular Cancer Therapies
Note: Standard treatment for testicular germ cell tumors relies on platinum-based chemotherapy regimens (BEP: bleomycin, etoposide, cisplatin) which achieve very high cure rates. There are no novel targeted or immunotherapy FDA approvals specifically for testicular cancer. The component drugs have general FDA approval and are used in established combination regimens.
Frequently Asked Questions
FAQWhy is it so curable?
Germ cell tumors' origin from pluripotent cells gives them intact apoptotic machinery and limited DNA repair, making them exquisitely cisplatin-sensitive.
What are tumor markers?
AFP, hCG, and LDH guide diagnosis, staging, and monitoring. Marker normalization confirms treatment response.
What is surveillance for stage I?
After orchiectomy, regular imaging and markers monitor for relapse rather than giving immediate treatment. 70-80% are cured by surgery alone.
Active Clinical Trials
PHASE 3 Late-Stage Pivotal Trials
TIGER (SWOG S1500)
Drug: Dose-Dense BEP vs Standard BEP
Population: Intermediate/poor-risk germ cell tumors
Status: Completed | NCT02582697 ↗
Search for additional trials on ClinicalTrials.gov ↗
PHASE 2 Efficacy and Safety Studies
Checkpoint Inhibitors for Refractory Disease
Drugs: Pembrolizumab, Nivolumab
Target: Platinum-refractory germ cell tumors
Search for additional trials on ClinicalTrials.gov ↗
PHASE 1 First-in-Human Dose-Finding Studies
Phase 1 trials establish safety profiles and determine recommended doses for novel anticancer agents in early-stage development.
Search for active Phase 1 trials on ClinicalTrials.gov ↗
Find Clinical Trials Near You
Interested in participating in a clinical trial? Visit ClinicalTrials.gov to search for trials by location, cancer type, and eligibility criteria. Discuss options with your oncologist to determine if clinical trial participation is appropriate for you.
Search ClinicalTrials.gov →🇪🇺 EU Clinical Pipeline (EudraCT Trials)
Active clinical trials registered in EU Clinical Trials Register
Phase 3 Trials
Late-stage European confirmatory trials
Phase 2 Trials
Mid-stage European efficacy trials
Phase 1 Trials
Early-stage European safety trials