Vascular fingerprint tool to identify patients with testicular cancer treated with cisplatin-based chemotherapy at high risk of early cardiovascular events.

Autor:	Meuleman AT; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Volders ELD; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Lubberts S; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Kerst JM; Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam., Wymenga ANM; Department of Medical Oncology, Medical Spectrum Twente, Enschede., Aarts MJB; Department of Medical Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, the Netherlands., Goncalves MB; Department of Medical Oncology, Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Lisboa, Portugal., Lefrandt JD; Department of Vascular Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Steursma G; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Meijer J; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Nuver J; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen., Gietema JA; Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen. Electronic address: j.a.gietema@umcg.nl.
Jazyk:	angličtina
Zdroj:	ESMO open [ESMO Open] 2024 Jul; Vol. 9 (7), pp. 103631. Date of Electronic Publication: 2024 Jul 13.
DOI:	10.1016/j.esmoop.2024.103631
Abstrakt:	Background: Patients with testicular cancer treated with chemotherapy have an increased risk of developing early cardiovascular events. Identification of patients with testicular cancer at a high risk of these events enables the development of preventative strategies. This study validates the vascular fingerprint tool to identify these patients. Patients and Methods: We carried out a multicenter prospective study in patients with metastatic testicular cancer [International Germ Cell Cancer Collaborative Group (IGCCCG) good or intermediate risk; retroperitoneal mass <5 cm]. In eligible patients, the vascular fingerprint was assessed before the start of cisplatin-based chemotherapy, which consists of five risk factors, namely, smoking, overweight (body mass index >25 kg/m 2 ), hypertension (blood pressure >140/90 mmHg), dyslipidemia (fasting cholesterol >5.1 mmol/l or low-density lipoprotein-cholesterol >2.5 mmol/l), and diabetes mellitus (fasting glucose ≥7.0 mmol/l). The presence of three or more risk factors was defined as high-risk vascular fingerprints. A log-rank test was carried out with a cardiovascular event within 1 year after the start of chemotherapy as the primary endpoint. Results: A total of 196 patients with metastatic testicular cancer were included; 15 patients (8%) developed a cardiovascular event: 4 (2%) arterial events and 11 (6%) venous thrombotic events. Overall, 189 vascular fingerprint scores were available. Patients with a high-risk vascular fingerprint (62/189) had a higher risk of developing a cardiovascular event (hazard ratio 3.27, 95% confidence interval 1.16-9.18; log-rank: P = 0.017). Histological diagnosis, prognosis group, cumulative chemotherapy dose, and retroperitoneal mass size did not differ between patients with or without a cardiovascular event. All patients with an arterial event had a high-risk vascular fingerprint compared with 5/11 patients with a venous event. Overweight was more prevalent in patients with cardiovascular events (87% versus 59%; P = 0.037). Conclusions: The vascular fingerprint is a validated tool to identify patients with testicular cancer at a high risk of developing early cardiovascular events. This tool can be used to develop preventative strategies with anticoagulant treatment. (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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