Abstract 737P
Background
Testicular cancer (TC) patients treated with chemotherapy (CT) have an increased risk of early cardiovascular events. This study aims to validate a vascular fingerprint tool developed to identify TC patients at high-risk for such events (Lubberts, Eur J Cancer 63:180, 2016).
Methods
A multicenter prospective study (NCT02573584) was performed in metastatic TC patients (IGCCCG good or intermediate risk; retroperitoneal mass <5 cm). The vascular fingerprint was assessed before start of CT and consists of 5 risk factors: smoking, overweight (BMI>25 kg/m2), hypertension (blood pressure >140/90 mmHg), dyslipidemia (fasting cholesterol >5.1 mmol/L or LDL >2.5 mmol/L) and diabetes mellitus (fasting glucose ≥ 7.0 mmol/L). Presence of ≥ 3 risk factors was defined as high-risk vascular fingerprint. A log-rank test was performed using a cardiovascular event within 1 year after start of CT as primary endpoint.
Results
196 TC patients were included; 15 patients (7.7%) developed a cardiovascular event: [ 4 (2.0%) arterial events and 11 (5.6%) venous thrombotic events]. TC patients with a high-risk vascular fingerprint (n=62) had a higher risk of developing a cardiovascular event (HR: 3.27; 95% CI: 1.16 – 9.18; Log-rank: p=0.017). All patients with an arterial event had a high-risk vascular fingerprint compared to 5/11 patients with a venous event. Patients who developed a cardiovascular event were older (Table).
Table: 737P
Risk factors before start of CT in TC patients with or without cardiovascular events
Cardiovascular event (n = 15) | No cardiovascular event (n = 181) | ||
Median (range) / n (%) | Median (range) / n (%) | P * | |
Age at start of CT, years | 40 (22-50) | 31 (17-48) | 0.013 |
SmokingOverweightHypertensionDyslipidemiaDiabetes mellitus | 5 (33.3)13 (86.7)7 (46.7)13 (86.7)1 (6.7) | 63 (34.8)107 (59.4)47 (26.6)113 (70.2)6 (3.5) | 0.908 0.037 0.1320.238 0.445 |
Total score vascular fingerprint | 3 (0-4) | 2 (0-4) | 0.035 |
High-risk vascular fingerprint | 9 (60.0) | 53 (30.5) | 0.041 |
∗X2-, Fisher’s exact- or Mann-Whitney U test
Conclusions
The vascular fingerprint tool is effective in identifying TC patients at high-risk for early cardiovascular events and can be used to select TC patients for preventative strategies.
Clinical trial identification
NCT02573584, 12 October 2015.
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
M.J.B. Aarts: Financial Interests, Institutional, Research Funding, Not related to current work; research funding site PI: Pfizer; Other, Institutional, Speaker, Consultant, Advisor: Amgen, Bristol Myers Squibb, Novartis, MDS-Merck, Merck-Pfizer, Pierre Fabre, Sanofi, Astellas, Bayer. M. Brito Goncalves: Other, Institutional, Speaker, Consultant, Advisor: Novartis, Pfizer, Merck Sharp Dohme, Astra. J.A. Gietema: Financial Interests, Institutional, Research Grant, Research grant paid to the institution UMCG: Roche, Siemens, AbbVie. All other authors have declared no conflicts of interest.
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