GU Cancers 2019 | PRIMETEST: evaluating retroperitoneal lymph node dissection

The PRIMETEST trial was a trial looking at the utility of RPLND, which is a surgical retroperitoneal lymph node dissection in patients with Stage IIA or Stage IIB seminoma. Now, as a background, we usually treat patients with Stage IIA or Stage IIB seminoma with either chemotherapy or radiation – that is the current standard of care.

The question here is that patients who recur, and a lot of the inclusion criteria for this study included patients who may have recurred when they were actively screened for their cancer, or there were prior carboplatin failures. They specifically excluded patients who’ve received prior radiation. The idea is can we improve the outcomes by doing RPLND in patients who have recurrent seminoma?

This was a fairly small study, there were a pilot test patient of 9 patients. There were another 14 patients, so they reported data on the 14 patients and found that their recurrence rates were in the order of 29%. Now the primary endpoint of this trial is really looking at the recurrence. They were allowed to continue with the trial if their recurrence rates were no more than 30%. So in essence, they met the primary endpoint, and the trial will continue.

Of course, it remains to be seen if this is gonna be a viable option for patients who have Stage IIA or Stage IIB seminoma, who have recurred.