Comprehensive Characterization of the Vascular Effects of Cisplatin-Based Chemotherapy in Patients With Testicular Cancer
| العنوان: | Comprehensive Characterization of the Vascular Effects of Cisplatin-Based Chemotherapy in Patients With Testicular Cancer |
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| المؤلفون: | Paul Welsh, Ashita Waterston, Augusto C. Montezano, Francisco J. Rios, Jeff White, Karla B Neves, Rhian M. Touyz, Patrick B. Mark, Kelly R. McMahon, Alan C. Cameron, Mark Hall, Ninian N. Lang |
| المصدر: | Jacc. Cardiooncology JACC. CardioOncology, Vol 2, Iss 3, Pp 443-455 (2020) JACC: CardioOncology |
| بيانات النشر: | Elsevier Inc, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Oncology, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, medicine.medical_treatment, cisplatin, BEP, bleomycin, etoposide and cisplatin, vWF, von Willebrand factor, atherosclerosis, cancer, chemotherapy, Bleomycin, lcsh:RC254-282, endothelial dysfunction, Nephrotoxicity, ICAM, intracellular adhesion molecule, chemistry.chemical_compound, Internal medicine, platinum therapy, medicine, 0FMD, flow-mediated dilatation, Endothelial dysfunction, germ cell tumors, t-PA, tissue plasminogen activator, Testicular cancer, Etoposide, thrombosis, Original Research, Cisplatin, Chemotherapy, business.industry, ACh, acetylcholine, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, testicular cancer, chemistry, lcsh:RC666-701, Cohort, SNP, sodium nitroprusside, PAI, plasminogen activator inhibitor, vasoreactivity, FBF, forearm blood flow, Cardiology and Cardiovascular Medicine, business, BK, bradykinin, Editorial Comment, medicine.drug |
| الوصف: | Background Cisplatin-based chemotherapy increases the risk of cardiovascular and renal disease. Objectives We aimed to define the time course, pathophysiology, and approaches to prevent cardiovascular disease associated with cisplatin-based chemotherapy. Methods Two cohorts of patients with a history of testicular cancer (n = 53) were recruited. Cohort 1 consisted of 27 men undergoing treatment with: 1) surveillance; 2) 1 to 2 cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy (low-intensity cisplatin); or 3) 3 to 4 cycles of BEP (high-intensity cisplatin). Endothelial function (percentage flow-mediated dilatation) and cardiovascular biomarkers were assessed at 6 visits over 9 months. Cohort 2 consisted of 26 men previously treated 1 to 7 years ago with surveillance or 3 to 4 cycles BEP. Vasomotor and fibrinolytic responses to bradykinin, acetylcholine, and sodium nitroprusside were evaluated using forearm venous occlusion plethysmography. Results In cohort 1, the percentage flow-mediated dilatation decreased 24 h after the first cisplatin dose in patients managed with 3 to 4 cycles BEP (10.9 ± 0.9 vs. 16.7 ± 1.6; p < 0.01) but was unchanged from baseline thereafter. Six weeks after starting 3 to 4 cycles BEP, there were increased serum cholesterol levels (7.2 ± 0.5 mmol/l vs. 5.5 ± 0.2 mmol/l; p = 0.01), hemoglobin A1c (41.8 ± 2.0 mmol/l vs. 35.5 ± 1.2 mmol/l; p < 0.001), von Willebrand factor antigen (62.4 ± 5.4 mmol/l vs. 45.2 ± 2.8 mmol/l; p = 0.048) and cystatin C (0.91 ± 0.07 mmol/l vs. 0.65 ± 0.09 mmol/l; p < 0.01). In cohort 2, intra-arterial bradykinin, acetylcholine, and sodium nitroprusside caused dose-dependent vasodilation (p < 0.0001). Vasomotor responses, endogenous fibrinolytic factor release, and cardiovascular biomarkers were not different in patients managed with 3 to 4 cycles of BEP versus surveillance. Conclusions Cisplatin-based chemotherapy induces acute and transient endothelial dysfunction, dyslipidemia, hyperglycemia, and nephrotoxicity in the early phases of treatment. Cardiovascular and renal protective strategies should target the early perichemotherapy period. (Clinical Characterisation of the Vascular Effects of Cis-platinum Based Chemotherapy in Patients With Testicular Cancer [VECTOR], NCT03557177; Intermediate and Long Term Vascular Effects of Cisplatin in Patients With Testicular Cancer [INTELLECT], NCT03557164) Central Illustration |
| اللغة: | English |
| تدمد: | 2666-0873 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2b7b0e33ae5e1978d0b80127f30701a6Test http://europepmc.org/articles/PMC7539369Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....2b7b0e33ae5e1978d0b80127f30701a6 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 26660873 |
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