Limited progress in clinical trials for rare urologic cancers
Testicular and penile cancer
DOI:
https://doi.org/10.5489/cuaj.9671Keywords:
Testicular cancer, Penile Cancer, Clinical trialsAbstract
Introduction: We aimed to characterize the contemporary landscape, completion rates, and predictors of completion of clinical trials in testicular and penile cancers.
Methods: We performed a registry-based cohort analysis of ClinicalTrials.gov to identify interventional and observational trials in testicular or penile cancer initiated between January 1, 2000, and October 1, 2025. Trials withdrawn before enrollment, supportive-care or non-oncologic studies, epidemiologic investigations, and basket trials without predefined disease-specific enrollment targets were excluded. Extracted variables included trial design, enrollment targets, funding source, geographic region, and completion status. Firth’s penalized logistic regression was used to assess predictors of trial completion. Kaplan-Meier and Cox proportional hazards models evaluated time to trial completion.
Results: Eighty-three eligible trials were identified, including 34 penile and 49 testicular cancer studies. Most trials were early-phase, non-randomized, and small. Overall completion rates were low (38% for penile cancer and 41% for testicular cancer), with no significant difference by disease site. Trials conducted outside North America were significantly more likely to complete than North American studies (adjusted odds ratio 10.21; 95% confidence interval [CI] 2.11–68.27). Time-to-event analyses similarly demonstrated faster completion among non-North American trials (multivariable hazard ratio 5.02, 95% CI 1.84–13.66).
Conclusions: Clinical trials in rare urologic cancers demonstrate persistently low completion rates and substantial geographic disparities, highlighting the need for improved international collaboration and alternative trial frameworks to enhance trial feasibility and completion.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:
- Post the Article on any Web site
- Translate or authorize a translation of the Article
- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.
The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.
You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.
The CUA also requires you to warrant the following:
- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
- That all individuals who have made a substantive contribution to the article are acknowledged;
- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
- That the Article does not libel or violate the privacy rights of any third party.
