TACkLE Study - Tackling Adverse Chemotherapy-associated Late Effects

Testicular cancer (TC) is a rare disease, which mostly affects young men aged 15-35 years. Their life expectancy has greatly improved due to the introduction of platinum-containing chemotherapy for disseminated TC in the late 1970s. Given the good prognosis of TC nowadays, prevention or early detection of late adverse effects of TC treatment has become increasingly important. Current literature suggests that TC treatment, and specifically exposure to platinum agents, is associated with increased risk of cardiovascular morbidity and mortality. The precise role of treatment components like platinum in the pathogenesis of cardiometabolic changes and cardiovascular disease (CVD) warrants further investigation, since it is not known if CVD develops through direct platinum-induced damage of the vascular wall or by mediation through development of cardiometabolic riskfactors. The aim of this study is to identify risk factors for development for CVD after treatment for TC. A more profound insight into pathophysiologic mechanisms and identification of risk factors for CVDs is needed to facilitate development of preventive strategies and to optimize survivorship care.

Sex

Male

Minimum age

18 Years

Maximum age

75 Years

All participating patients have to meet the following criteria:

* Alive
* TC diagnosis between 01-01-1976 to 31-12-2007
* TC treatment center: UMCG, NKI/AVL, Erasmus MC, UMCN, LUMC
* Younger than 50 years of age at TC diagnosis
* Written informed consent

Cases have to fulfill, beside the aforementioned criteria, the following criteria:

* Diagnosed with either myocardial infarction (MI), proven coronary artery disease (CAD) (CTCAE-4 grade 2 or higher) or congestive heart failure (CHF) (CTCAE-4 grade 2 or higher).
* No medical history of CVD before diagnosis of TC

In order to be eligible to participate in the cardiometabolic risk inventory study (and to be invited to a study assessment), a subject must meet, next to the criteria mentioned in "1)", the following inclusion criteria:

* Younger than 40 years of age at TC diagnosis
* Younger than 75 years of age at moment of inclusion

Exclusion criteria:

A potential subject who meets any of the following criteria will be excluded from participation in this study:

* Mental disorder (no informed consent available)
* Presence of active malignant disease

• DERIVEDLubberts S, Groot HJ, de Wit R, Mulder S, Witjes JA, Kerst JM, Groenewegen G, Lefrandt JD, van Leeuwen FE, Nuver J, Schaapveld M, Gietema JA. Cardiovascular Disease in Testicular Cancer Survivors: Identification of Risk Factors and Impact on Quality of Life. J Clin Oncol. 2023 Jul 1;41(19):3512-3522. doi: 10.1200/JCO.22.01016. Epub 2023 Apr 18. PMID 37071834