Carboplatin Monotherapy Induced Complete Response in Elderly Metastatic Seminoma and CKD: A Case Report

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.

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.

Carboplatin monotherapy may be a feasible alternative for metastatic seminoma patients who are unsuitable for cisplatin-based chemotherapy.