Health Consequences Vary by Chemo Regimen in Testicular Cancer Survivors

Long-term morbidity varies by chemotherapy regimen, with higher odds of worse renal impairment seen with EPx4 versus BEPx3
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MONDAY, March 2, 2026 (HealthDay News) -- For testicular cancer survivors (TCS), long-term morbidity varies with National Comprehensive Cancer Network (NCCN)-endorsed chemotherapy regimens, according to a study published online Feb. 19 in the Journal of the National Comprehensive Cancer Network.

Sarah L. Kerns, Ph.D., M.P.H., from The Medical College of Wisconsin in Milwaukee, and colleagues quantified the cumulative burden of morbidity (CBM) scores, including renal function, in 798 long-term TCS treated with contemporary NCCN-endorsed regimens of four cycles of etoposide/cisplatin (EPx4) or three or four cycles of bleomycin/etoposide/cisplatin (BEPx3/BEPx4).

The median age at follow-up was 45 years (median of 11 years postchemotherapy). The researchers found that compared with BEPx3, TCS receiving EPx4 had significantly increased odds of worse renal impairment, ototoxicity, and neuropathy (adjusted odds ratios, 1.55, 1.48, and 1.77, respectively). A reduced estimated glomerular filtration rate (eGFR) was seen in 41 percent of TCS and was associated with cumulative cisplatin dose and with increased odds of developing hypertension (odds ratios, 2.01, 2.84, and 20.0 for 60 to 89, 45 to 59, and 30 to 44 mL/min/1.73 m2, respectively). Significantly increased odds of developing hyperlipidemia and/or cardiovascular disease were seen in association with moderate-to-severe eGFR reductions (30 to 44 mL/min/1.73 m2; odds ratios, 6.10 and 7.09, respectively). Similar CBM scores were seen after EPx4 versus BEPx3, but scores were worse after BEPx4 or four cycles of etoposide/ifosfamide/cisplatin (adjusted odds ratios, 1.77 and 2.24, respectively). There were strong correlations for self-reported global physical health with CBM score and chemotherapy regimen.

"While today's standard chemotherapy regimens are highly effective at curing testicular cancer, they're associated with meaningful long-term health risks that appear to differ by treatment approach," Kerns said in a statement.

One author disclosed ties to the biopharmaceutical and medical technology industries.

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