Based on the ambition to provide a cure to every child and young adult with cancer while maintaining optimal quality of life, Dr. Looijenga highlighted the mission to provide diagnosis, treatment, and follow-up using the most informative tools to maximize treatment efficacy while minimizing long-term morbidity. This relies upon their vision to develop a multi-modal developmental biology-based research to generate tools to improve the care of patients with germ cell tumors. This relies on an integrative approach including specialists from surgery, medical oncology, radiation oncology, radiology, pathology, and integrative support services.
In patients with germ cell tumors, fertility preservation is an important component of maintaining the quality of life following cancer treatment.
Recently, the International Society of Urological Pathology assessed utilization of molecular-genetic tests for patients with testicular germ cell tumors, highlight seven types of germ cell tumors, from a developmental perspective.
Dr. Looijenga then examined the existing literature demonstrating a complex interaction between shared pre-disposing factors and post-diagnostic effects which may contribute to the shared epidemiologic association between testicular cancer and infertility. Certainly, the effects of surgery, chemotherapy, and radiotherapy may contribute to infertility, particularly in those at elevated risk of baseline sub-fertility or infertility.
Dr. Looijenga then highlighted the GCNIS block of the spermatogonia stem cell as the earliest pathogenetic link between testicular carcinogenesis and infertility.
In recent years, the assessment of micro RNAs (miRNAs) has been developed as a liquid biopsy biomarker for patients with testicular cancer. Some of these biomarkers, including miR-371a-3p and XIST methylation, may also act as biomarkers for spermatogenesis quality.
In closing, Dr. Looijenga highlighted the importance of micro-environmental interactions between infertility and testis cancer.
Presented by: Leendert Looijenga, Principal Investigator, Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands
Written by: Christopher J.D. Wallis, Urologic Oncology Fellow, Vanderbilt University Medical Center, @WallisCJD on Twitter, at the Virtual 2020 EAU Annual Meeting #EAU20, July 17-19, 2020.