Association of PAI-1 gene polymorphism with survival and chemotherapy-related vascular toxicity in testicular cancer.

Background: High Plasminogen-Activator Inhibitor 1 (PAI-1) expression by tumors has been associated with poor prognosis in several cancer types, and high systemic PAI-1 levels with increased thrombosis risk. The authors investigated whether the germline 4G/5G deletion/insertion polymorphism in the PAI-1 promoter (rs1799889), which may influence PAI-1 expression, is associated with survival and chemotherapy-related vascular toxicity in testicular cancer (TC).

Methods: Data were collected on PAI-1 4G/5G polymorphism, survival, venous thromboembolism (VTE), and coronary heart disease (CHD) for 324 non-seminomatous TC patients treated with platinum-based chemotherapy.

The metabolic syndrome in cancer survivors.

The metabolic syndrome, as a cluster of cardiovascular risk factors, may represent an important connection between cancer treatment and its common late effect of cardiovascular disease. Insight into the aetiology of the metabolic syndrome after cancer treatment might help to identify and treat cancer survivors with increased cardiovascular risk. In this review, we summarise current knowledge on the prevalence and pathophysiology of the metabolic syndrome in cancer survivors, and discuss current intervention strategies with an emphasis on new developments.

Clinical and therapeutic aspects of extrapulmonary small cell carcinoma.

Extrapulmonary small cell carcinoma (EPSCC) is usually treated similarly to small cell lung cancer. Differences in aetiology, clinical course, frequency of brain metastases, and survival, however, warrant a differential therapeutic approach. In this review, we focus on the treatment of the most predominant sites of origin of EPSCC; the gastrointestinal tract, the genitourinary tract, the head and neck region, and small cell carcinoma of unknown primary.

Semen quality in men with disseminated testicular cancer: relation with human chorionic gonadotropin beta-subunit and pituitary gonadal hormones.

Objective: To compare the semen quality and hormonal status between patients with testicular cancer and normal versus increased serum levels of beta-hCG.

Design: Retrospective study.

Setting: Academic research environment.

Variation in bleomycin hydrolase gene is associated with reduced survival after chemotherapy for testicular germ cell cancer.

Purpose: Response to chemotherapy may be determined by gene polymorphisms involved in metabolism of cytotoxic drugs. A plausible candidate is the gene for bleomycin hydrolase (BLMH), an enzyme that inactivates bleomycin, an essential component of chemotherapy regimens for disseminated testicular germ-cell cancer (TC). We investigated whether the single nucleotide polymorphism (SNP) A1450G of the BLMH gene (rs1050565) is associated with survival.

Clinical and genetic aspects of testicular germ cell tumours.

In this paper we review clinical and genetic aspects of testicular germ cell tumours (TGCTs). TGCT is the most common type of malignant disorder in men aged 1540 years. Its incidence has increased sharply in recent years.

Cardiotoxicity associated with the use of trastuzumab in breast cancer patients.

The monoclonal antibody against HER2, trastuzumab (Herceptin), has become an important player in the treatment of patients with HER2-positive breast cancer. Both in the metastatic and adjuvant setting, the addition of trastuzumab to other systemic treatments has led to a striking increase in tumor response and survival. The downside with the use of this agent, however, is its inherent cardiotoxicity, which is particularly common when anthracyclines are used concurrently.

The therapeutic challenge of a nonresectable solitary fibrous tumor in a hypoglycemic patient.

We report a patient with a nonresectable histologically benign solitary fibrous tumor who suffered from paraneoplastic non-islet cell tumor hypoglycemia (NICTH). Diagnostic workup revealed malignant characteristics in which the tumor showed up as, presumably, false-negative on fluorodeoxyglucose-positron emission tomography (FDG-PET), while being positive on tyrosine-PET. Neoadjuvant treatment, which consisted of combined chemo-radiation and consecutive selective embolization of the tumor feeding vessels, caused such a therapeutic effect, on both NICTH and reduction in tumor volume, that a secondary resection, with the patient in a normoglycemic status, was possible.

The relation between soluble apoptotic proteins and subclinical cardiotoxicity in adjuvant-treated breast cancer patients.

Background: Circulating apoptotic proteins are increased in heart failure patients. We evaluated whether circulating soluble apoptosis-related protein levels change after anthracycline-containing chemotherapy and radiotherapy in relation to cardiac dysfunction or the applied treatment.

Patients And Methods: Circulating apoptotic proteins were measured with immunoassay in 40 breast cancer patients following surgery (TO), one month (T1) and one year (T2) after epirubicin-based chemotherapy.

Testicular cancer: a longitudinal pilot study on stress response symptoms and quality of life in couples before and after chemotherapy.

Goals Of Work: The current study was designed to longitudinally examine stress response symptoms (SRS) and quality of life (QoL) in couples confronted with disseminated testicular cancer. The objectives were to examine couples' patterns of adjustment over time and possible differences in adjustment between the patient and his partner.

Materials And Methods: Couples completed the Impact of Event Scale and the QoL subscales physical functioning, social functioning, and mental health of the RAND-36 before chemotherapy (T1), after completion of chemotherapy (T2), and 1 year later (T3).

Predicting retroperitoneal histology in postchemotherapy testicular germ cell cancer: a model update and multicentre validation with more than 1000 patients.

Objectives: Surgical resection of postchemotherapy retroperitoneal lymph nodes is often performed in patients with advanced nonseminomatous testicular germ cell cancer. We previously developed a model to predict the probability that the lymph nodes contain only necrotic or fibrotic (benign) tissue versus mature teratoma and viable cancer (tumour) to identify patients who actually need resection. The present study used an updated model with new patient data and studied the validity of the updated model across various settings.

Serum HER2 levels are increased in patients with chronic heart failure.

Background: The use of trastuzumab, an antibody against the human epidermal growth factor receptor 2 (HER2), in patients with HER2 positive metastatic breast cancer, is related to cardiotoxicity.

Aims: To investigate whether serum HER2 is increased in heart failure patients and related to disease severity.

Methods: Serum HER2, plasma tumor necrosis factor (TNF)-alpha and its soluble (s) receptors (sTNF-R1 and 2) were determined with ELISA in chronic heart failure patients and age and gender-matched healthy controls.

Self-esteem, social support, and mental health in survivors of testicular cancer: a comparison based on relationship status.

Testicular cancer is the most frequent malignancy in men between 20 and 40 years of age. This is a period in life in which important life events take place, such as starting a career and establishing a relationship. The goal of the study was to explore self-esteem, social support, and mental health in 3 groups of survivors of testicular cancer: singles, those with the same partner as at diagnosis (relationship during testicular cancer), and those with a partner they met after completion of treatment (relationship after testicular cancer).

Indium-111-labeled trastuzumab scintigraphy in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer.

Purpose: The cardiac and antineoplastic effects of trastuzumab may be related to specific uptake of trastuzumab in myocardium and tumor tissue, respectively. We evaluated whether indium-111 (111In)-labeled trastuzumab scintigraphy can predict cardiotoxicity and identify tumor lesions. In addition, we evaluated whether plasma markers for cardiac dysfunction can be used to predict cardiotoxicity.

Circulating apoptotic proteins are increased in long-term disease-free breast cancer survivors.

Circulating apoptotic proteins are increased in patients with heart failure. We evaluated whether circulating soluble (s) apoptosis-related proteins and inflammation markers are increased in long-term disease free breast cancer survivors and associated with cardiotoxicity, and if subgroups could be identified based on the applied treatments. Circulating tumour necrosis factor (TNF) alpha, sTNF-receptor (sTNF-R) 1 and 2, sFas, sFas ligand, sTNF-related apoptosis inducing ligand (sTRAIL) and serum HER2 were measured with immunoassay.

Prevalence, changes in and correlates of fatigue in the first year after diagnosis of testicular cancer.

Aim: To examine fatigue among testicular cancer patients during the first year after diagnosis.

Patients And Methods: Fifteen patients treated with orchidectomy (group 1) and 37 treated with orchidectomy plus chemotherapy (group 2) were assessed within 1 month after orchidectomy, and 3 and 12 months later. Fatigue, sociodemographics, anemia, testosterone levels and trait anxiety were assessed.

Acute chemotherapy-induced cardiovascular changes in patients with testicular cancer.

Purpose: After cisplatin- and bleomycin-containing chemotherapy for testicular cancer, part of the patient population will develop acute or long-term cardiovascular toxicity. It is largely unknown whether standard tests can be used to assess chemotherapy-induced cardiovascular changes.

Patients And Methods: In 65 testicular cancer patients (median age, 27 years; range, 18 to 48 years), we measured the following cardiovascular parameters before and within 10 weeks after completion of cisplatin-based chemotherapy: platelet numbers, plasma levels of hemostatic and fibrinolytic factors, 24-hour ambulatory blood pressure, baroreflex sensitivity, intima-media thickness of the common carotid artery, and flow-mediated vasodilation of the brachial artery.

Genetic variation in the bleomycin hydrolase gene and bleomycin-induced pulmonary toxicity in germ cell cancer patients.

Objective: Use of bleomycin as a cytotoxic agent is limited by its pulmonary toxicity. Bleomycin is mainly excreted by the kidneys, but can also be inactivated by bleomycin hydrolase (BMH). An 1450A>G polymorphic site in the BMH gene results in an amino acid substitution in the C-terminal domain of the protein.

Classification and occurrence of clinically significant drug interactions with irinotecan and oxaliplatin in patients with metastatic colorectal cancer.

Background: Pharmacokinetic and pharmacodynamic drug interactions with cytotoxic drugs may significantly influence the efficacy and toxicity of chemotherapy.

Objective: The purpose of this study was to identify drug interactions with irinotecan and oxaliplatin reported in the literature, to assess their clinical significance, and to examine the occurrence of these interactions in patients with metastatic colorectal cancer treated with either irinotecan or oxaliplatin or both.

Methods: To obtain data on drug-drug interactions with irinotecan and oxaliplatin, a literature search of PubMed and EMBASE was conducted using the search terms irinotecan, oxaliplatin, and interactions (English-language studies only published between 1980 and August 2004).

The metabolic syndrome and disturbances in hormone levels in long-term survivors of disseminated testicular cancer.

Purpose: The metabolic syndrome may be an important risk factor for cardiovascular disease in long-term survivors of testicular cancer (TC). We investigated the associations between hormone levels and the metabolic syndrome in these men.

Patients And Methods: We included TC patients cured by orchidectomy and cisplatin-based chemotherapy, stage I TC patients after orchidectomy only, and healthy men of comparable age.