Experts Discuss the Landscape of Testicular Cancer During Testicular Cancer Awareness Month

In honor of Testicular Cancer Awareness Month, Mina M. Fam, MD, the medical director of urologic oncology at Jersey Shore University Medical Center and the medical director of robotic surgery at Ocean University Medical Center, and Bradley McGregor, MD, the director of clinical research at the Lank Center for Genitourinary Oncology, an institute physician, and the Marra Lochiatto Investigator at Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School, discussed the current treatment landscape of the disease, emerging therapies in the space, and avenues for future research.

Early detection through testicular self-exams is vital, as diagnosing the disease early often leads to less intensive treatment and better clinical outcomes, Fam said. Despite high cure rates, testicular cancer remained the fourth-highest cause of cancer death in the United States for men aged 20 to 39 in 2023.

Although cisplatin-based chemotherapy is the cornerstone of current treatment, significant unmet needs exist for patients with relapsed or refractory disease, Fam explained. To address this, the international phase 3 TIGER study (NCT02375204) is currently comparing standard-dose chemotherapy against high-dose chemotherapy combined with autologous stem cell transplant, McGregor said. Furthermore, early research into novel therapies, such as the CLDN6-targeted CAR T-cell therapy BNT211, has shown promising response rates for patients with germ cell tumors.

A major focus of modern care is long-term survivorship, as many patients face adverse effects decades after their initial treatment, Fam said. Survivors are at an increased risk for cardiovascular disease, secondary malignancies, and endocrine dysfunction, such as hypogonadism. Approximately 25% to 40% of survivors experience sexual dysfunction, and although many achieve fatherhood naturally, sperm cryopreservation is recommended as a proactive measure before undergoing an orchiectomy.

Looking forward, the experts advocated for tailored treatment approaches and the use of new biomarker assays to identify patients at high risk for recurrence. Because these patients are often young at the time of diagnosis, care must transition into a lifelong management model to address psychosocial and physical challenges that persist long after treatment ends, they explained.