Virtual Active Surveillance for Testicular Cancer

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: University Health Network, Toronto

Disqualifiers: Metastatic disease, TCa relapse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

144 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial is testing WATChmAN, an online system for testicular cancer patients to manage their follow-up care virtually. It aims to make follow-ups easier and more convenient by reducing the need for regular hospital visits. Patients will receive reminders, check their results, and communicate with doctors through the platform.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment WATChmAN Virtual Testicular Cancer Clinic for testicular cancer?

Research suggests that using telemedicine, like the WATChmAN Virtual Testicular Cancer Clinic, can help improve patient adherence to surveillance protocols by reducing the burden of frequent office visits and tests, which may enhance quality of life and compliance with follow-up care. ^{1 2 3 4 5}

Is virtual active surveillance for testicular cancer safe?

The safety of virtual active surveillance for testicular cancer isn't directly addressed in the available research, but active surveillance in general is considered an acceptable alternative to more aggressive treatments, with reduced toxicity and similar survival rates. However, maintaining regular follow-up is crucial to avoid late detection of recurrence. ^{4 6 7 8 9}

How is the WATChmAN Virtual Testicular Cancer Clinic treatment different from other treatments for testicular cancer?

The WATChmAN Virtual Testicular Cancer Clinic is unique because it uses virtual surveillance, which can reduce the need for frequent in-person visits and imaging tests, potentially improving patient quality of life and adherence to follow-up care. ^{1 2 3 10 11}

Research Team

Robert Hamilton, MD

Principal Investigator

The Princess Margaret Cancer Foundation

Eligibility Criteria

This trial is for men over 18 who can understand English, have access to a digital device, and have had stage 1 testicular cancer treated with orchiectomy within the last 9 months. They should be ready to follow a strict check-up schedule. Men with metastatic disease or relapse in the first 9 months, or poor computer skills as judged by the study team cannot join.

Inclusion Criteria

I had surgery to remove a testicle due to cancer and am being closely monitored.

I am a man aged 18 or older.

Can read, write, and speak English

Exclusion Criteria

My cancer spread or came back within 9 months of starting active surveillance.

The study team considers my computer skills or ability to follow the study plan as inadequate.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Active Surveillance

Participants undergo active surveillance with blood work and imaging at regular intervals to detect relapse at a curable stage

5-9 years

Multiple visits over 5-9 years, both in-person and virtual

Follow-up

Participants are monitored for safety and effectiveness after active surveillance

4 weeks

Virtual Platform Development

Development and implementation of the WATChmAN virtual platform for testicular cancer follow-up

1 year

Treatment Details

Interventions

• WATChmAN Virtual Testicular Cancer Clinic

Trial Overview The WATChmAN project is testing a web-based virtual clinic against traditional in-person visits for monitoring testicular cancer patients under active surveillance. The goal is to see if online follow-ups can improve patient satisfaction and adherence while reducing costs.

Participant Groups

Group I: WATChmAN Experimental Treatment 1 Intervention

Patients randomized to the WATChmAN Active Surveillance arm will receive their active surveillance testicular cancer care via an online virtual clinic. Importantly, patients will follow the same surveillance schedule as patients in the standard of care arm. However, patients in the WATChmAN arm will be able to see their upcoming tests and virtual appointments online, request requisitions to perform their required testing at outside institutions, and indicate any concerns for physicians to review during the virtual visit.

Group II: Standard of Care Active Control 1 Intervention

Patients randomized to the standard of care arm (in-person active surveillance) will follow the current active surveillance protocol in place at Princess Margaret Cancer Centre's Multidisciplinary Testicular Cancer Clinic. This protocol involves the same schedule of testing as the WATChmAN arm, but will require patients to come into the clinic to receive their test results (as in current practice).

Who Is Running the Clinical Trial?

University Health Network, Toronto

Lead Sponsor

Trials

1,555

Recruited

526,000+

References

1. England pubmed.ncbi.nlm.nih.gov

Patterns of management and surveillance imaging amongst medical oncologists in Australia for stage I testicular cancer. [2015]

2. China pubmed.ncbi.nlm.nih.gov

Novel approaches to redesign surveillance strategies following orchiectomy for localized testicular cancer: a narrative review. [2023]

3. Switzerland pubmed.ncbi.nlm.nih.gov

How to improve adherence of guidelines for localized testicular cancer surveillance: A Delphi consensus study. [2023]

4. Australia pubmed.ncbi.nlm.nih.gov

Compliance of males with stage 1 testicular germ cell tumours on an active surveillance protocol. [2015]

5. Italy pubmed.ncbi.nlm.nih.gov

Testicular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Review of late complications of treatment and late relapse in testicular cancer. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Complications associated with chemotherapy in testicular cancer management. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Non-risk-adapted surveillance for patients with stage I nonseminomatous testicular germ-cell tumors: diminishing treatment-related morbidity while maintaining efficacy. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Testis Cancer Care in North Carolina: Implications for Real-World Evidence and Cancer Surveillance. [2022]

10. Germany pubmed.ncbi.nlm.nih.gov

Comparison of low dose with standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer under surveillance. [2021]

11. Canada pubmed.ncbi.nlm.nih.gov

Surveillance programs for early stage non-seminomatous testicular cancer: a practice guideline. [2018]