Improving the Understanding of Late Effects of Testicular Cancer in Adolescent and Young Adult Survivors: TRANSCEND-XR.

Testicular cancer (TC) is the most common malignancy amongst adolescents and young adults (AYAs) aged 15-39 years assigned male at birth. Survivors often experience late effects of treatment and report unmet supportive care needs.

To present the protocol for the TRANSCEND-XR project (TesticulaR cANcer late effects and unmet Supportive CarE NeeDs of AYA survivors using eXtended Reality).

TRANSCEND-XR aims to ethically co-create, test, and scale up in a clinical setting an innovative digital intervention to increase AYA TC survivors' knowledge of the late effects of TC treatment and address their unmet supportive care needs using XR. Delivered by a consortium of 15 partners across 12 European countries, guided by the Medical Research Council's framework for complex interventions, and funded by the European Union, TRANSCEND-XR is structured into three phases: co-creation and validation (Phase 1); implementation and evaluation (Phase 2); and impact, guideline development, policy, dissemination, and exploitation (Phase 3).

Phase 1 involves a cross-sectional survey of 500 AYA TC survivors to assess late effects and care needs as well as participatory World Café sessions with healthcare professionals, survivors, and care partners (n = 200) to co-design the TRANSCEND-XR intervention. Phase 2 includes a multicentre, single-arm phase 2 pilot trial (n = 15) across three clinical sites in three countries evaluating intervention feasibility, and a multicentre pragmatic randomised controlled phase 3 trial (n = 230) across eight clinical sites in seven countries, evaluating improvements in knowledge of late effects, cost-effectiveness, implementation, and ethical considerations. Phase 3 focuses on guideline development, policy influence, and strategic dissemination to ensure long-term sustainability and integration into European healthcare systems.

TRANSCEND-XR aims to transform survivorship care for AYA TC survivors through a co-created, scalable XR intervention. Its interdisciplinary approach promotes scientific rigour, stakeholder engagement, and policy relevance to improve long-term outcomes and quality of life.

TRANSCEND-XR has the potential to advance survivorship care standards for AYAs with TC whilst providing a model for future digital health interventions in oncology.

Andrology. 2026 May 25 [Epub ahead of print]

Mohamad M Saab, Josephine Hegarty, Jack P Gleeson, David Murphy, Sheena McHugh, Frances Shiely, Aileen Murphy, Ann Kirby, Ida J Korfage, Sophie Terhaard, Agnes van der Heide, Johannes Sivesgaard, Matias Katajavaara Seidler, Anna Patrikidou, Davor Ježek, Lynda Corrigan, Patrice Kearney Sheehan, Daniele Raggi, Alison Reid, Michal Chovanec, Patrizia Gianntempo, Jourik A Gietema, Justine Fleur van der Feen, Francisco Lupiáñez-Villanueva, Ana Roca-Umbert, Joanne Reid, Paulo Alves, Joana Soares, Karen Galvin, Michal Kubo, Maria O'Malley

Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland., Cancer Research Centre, College of Medicine and Health, University College Cork, Cork, Ireland., School of Computer Science and Information Technology, University College Cork, Cork, Ireland., School of Public Health, University College Cork, Cork, Ireland., Department of Economics, Cork University Business School, University College Cork, Cork, Ireland., Erasmus MC, Department of Public Health, University Medical Center Rotterdam, Rotterdam, the Netherlands., Khora, Copenhagen, Denmark., Gustave Roussy, Villejuif, France., School of Medicine, Centre of Excellence for Reproductive and Regenerative Medicine, University of Zagreb, Zagreb, Croatia., Tallaght University Hospital, Dublin, Ireland., The Royal Marsden NHS Foundation Trust, London, UK., Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia., Fondazione Irccs Istituto Nazionale Dei Tumori, Milan, Italy., Academisch Ziekenhuis Groningen, Groningen, the Netherlands., PredictBy Research and Consulting, Barcelona, Spain., The School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK., Center For Interdisciplinary Research in Health, Faculty of Health Sciences and Nursing, Catholic University of Portugal, Porto, Portugal., FundtoInnovate Limited, Cork, Ireland., Association of European Cancer Leagues, Brussels, Belgium.