Latent Vascular Effects of Chemotherapy for Testicular Cancer
Research type
Research Study
Full title
Understanding the Intermediate and Long Term Vascular Effects of Cisplatin Based Chemotherapy in Patients with Testicular Cancer
IRAS ID
192296
Contact name
Ninian Lang
Contact email
Sponsor organisation
NHS Greater Glasgow & Clyde
Duration of Study in the UK
0 years, 11 months, 27 days
Research summary
Testicular cancer is the most common cancer in men aged 20 to 40. The prognosis is very good, with the vast majority of patients cured. Patients with high risk or metastatic disease receive surgery followed by chemotherapy that consists of bleomycin, etoposide and cisplatin (BEP).
BEP chemotherapy is associated with long-term cardiovascular side effects, including ischaemic heart disease, blood clots and stroke, primarily related to the platinum containing agent cisplatin.
The time course effects of cisplatin on cardiovascular health are incompletely understood. Several studies have demonstrated increased long-term risk of cardiovascular disease, with one study demonstrating up to 7-fold increased risk of major cardiovascular event over 14 years. A more recent study of 15,000 patients has suggested the increased cardiovascular risk may be limited to the first year after chemotherapy. The time course effects of cisplatin based chemotherapy on cardiovascular health are therefore incompletely defined.
The endothelium is a single cell layer covering all healthy blood vessels. Endothelial dysfunction is central to the development of cardiovascular side effects associated with BEP chemotherapy. Endothelial dysfunction can be assessed using flow-mediated dilatation (FMD) and venous occlusion plethysmography. FMD measures brachial (forearm) artery responses to blood flow whilst venous occlusion plethysmography measures changes in forearm blood flow in response to agents administered via the brachial artery at doses which do not affect the rest of the body.
We wish to examine the nature and time course of cardiovascular effects of cisplatin based chemotherapy for testicular cancer. A randomised trial of statin therapy is under consideration in these patients and results from this pilot study will help inform its design. It will allow us to direct pharmacological interventions towards the most appropriate pathophysiological processes, at the most appropriate time and in the most appropriate patient groups treated with cisplatin based chemotherapy for testicular cancer.
REC name
West of Scotland REC 4
REC reference
16/WS/0030
Date of REC Opinion
9 Mar 2016
REC opinion
Further Information Favourable Opinion