Case report reveals carboplatin monotherapy effectively treats metastatic seminoma in an elderly man with CKD, suggesting alternative options.
Background Cisplatin‐based chemotherapy is the standard treatment for metastatic seminoma but may be unsuitable for elderly patients with comorbidities. We report a case of metastatic seminoma with chronic kidney disease (CKD) in an elderly patient successfully treated with carboplatin monotherapy. Case Presentation A 70‐year‐old man presented with a left testicular tumor and para‐aortic lymphadenopathy, causing left‐sided hydronephrosis. Radical left high orchiectomy confirmed stage IIC pure seminoma pT1N3M0 with a favorable prognosis according to the International Germ Cell Cancer Collaborative Group classification. Because renal impairment and poor performance status precluded cisplatin‐based chemotherapy, the patient received four cycles of carboplatin monotherapy (AUC 7). Grade 2–3 pancytopenia occurred but was manageable with pegfilgrastim and dose interval adjustment. Post‐treatment PET‐CT showed no residual uptake. Consolidation para‐aortic radiotherapy was subsequently performed. The patient remains disease‐free 1.5 years after treatment. Conclusion Carboplatin monotherapy may be a feasible alternative for metastatic seminoma patients who are unsuitable for cisplatin‐based chemotherapy.
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Omae et al. (2026) studied this question.
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