Symptoms and General Pathology

All Conditions

Heart and Blood Diseases

Gland and Hormone Related Diseases

Nutritional and Metabolic Diseases

Neoplasms

Rare Diseases

Syndrome

Hypertension

Cushing Syndrome

Metabolic Syndrome

Adrenocortical Adenoma

Adrenal Gland Neoplasms

Adenoma

Adrenal Cortex Neoplasms

Endocrine Gland Neoplasms

Adrenal Cortex Diseases

Adrenal Gland Diseases

Endocrine System Diseases

Cushing's Syndrome

Adenoma of the Adrenal Gland

Anti-Inflammatory Agents

All Drugs and Chemicals

Vasoconstrictor Agents

Respiratory System Agents

Antihypertensive Agents

Channel Blockers

Vasodilator Agents

Natriuretic Agents

Hydrocortisone

Hydrocortisone 17-butyrate 21-propionate

Hydrocortisone acetate

Hydrocortisone hemisuccinate

Epinephrine

Amlodipine

Spironolactone

Angiotensin Receptor Antagonists

Angiotensin II

Giapreza

Angiotensinogen

Racepinephrine

Epinephryl borate

Prazosin

Enzyme Inhibitors

Angiotensin-Converting Enzyme Inhibitors

Bisoprolol

Diltiazem

Indapamide

Adrenergic Agents

Adrenergic alpha-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Adrenergic beta-Agonists

Bronchodilator Agents

Anti-Asthmatic Agents

Mydriatics

Sympathomimetics

Laparoscopic surgical removal of the adrenal tumor

Standardized medical treatment of hypertension by SAHR.

Standardized anti-hypertensive drug regimen has been established according to international recommendations and includes the following steps:

* step 1: Angiotensin converting enzyme inhibitor (ACE-I) or angiotensin II receptor antagonist (ARBs) at half-dose (Ranipril 5mg or Ibesartan 150 mg )
* step 2: CEI or ARA2 at full dose (Ranipril 10 mg or Ibesartan 300 mg)
* step 3: Add-on of Amlodipine 10 mg or Diltiazem LP 300 mg
* step 4: Add-on of Indapamide LP 1.5 mg
* step 5: Add-on of Spironolactone 25 mg
* step 6: Add-on of Bisoprolol 10 mg
* step 7: Add-on of Prazosine LP 5mg/day.

Standardized medical treatment of hypertension by SAHR

Eric FRISON, Dr

The general objective is to evaluate the consequences of surgical removal of SCSI on hypertension and cardiovascular risk factors in order to determine on an evidence-based basis if surgical excision of SCSI is preferable to an intensive medical regimen in patients with hypertension.

Adrenal incidentalomas are unsuspected adrenal masses found during abdominal imaging. With the widespread use of computed tomography and MRI, adrenal incidentalomas are found in approximately 2% of patients. In an endocrinology setting, the majority of these masses are benign adenomas of the adrenal cortex. Approximately 10% of these adenomas display little excess of cortisol secretion associated to some degree of secretory autonomy but that are insufficient to generate overt Cushing's syndrome ("Subclinical Secreting Cortisol incidentalomas" or SCSI). However, hypertension and to a lesser degree obesity and impaired glucose tolerance are very frequent amongst patients with SCSI. The hypothesis that the mild hypercortisolism associated with SCSI is responsible for these clinical consequences is substantiated by few studies describing improvement after resection of SCSI. However, these studies were retrospective, uncontrolled and suffered from imprecision and numerous methodological bias. Thus, whether surgery is more beneficial than medical treatment is currently unknown and there is no consensus on the appropriate treatment for SCSI.

Patient selection Run-In period. Discontinuation of previous antihypertensive treatments and prescription of a standardized anti-hypertensive drug regimen (SAHR). Monthly Blood Pressure (BP) measurement using home BP monitoring. The duration of the Run-In periods will be ≤ 6 months and will end when BP will be controlled with the SAHR at two consecutive visits.

End of RI Second endocrine assessment for eligibility Randomization (Ra): 24h Ambulatory BP measurement, anthropometric and metabolic evaluation. Quality of life and cognition questionnaires. Randomization in 2 groups : Gr 1 Treatment group : Surgery followed by intensive medical care ; Gr 2 : Control Group : intensive medical care only.

Ra + 1Mo: Surgery in Group 1 Ra + 2.5 Mo to Ra + 13 Mo: 6 weeks interval follow-up Evaluation of home BP monitoring and adaptation of the SAHR. A step by step reduction of the SAHR will be attempted in the two patient groups at Ra+2.5Mo. A second attempt will systematically be performed in both groups at Ra+8.5 Medical evaluation of associated metabolic conditions (obesity, diabetes, dyslipidemia) and adaptation of treatments Record of medical events and side effects of treatments Ra + 13Mo: Final evaluation. Endocrine assessment. 24h Ambulatory BP measurement, anthropometric and metabolic evaluation. Quality of life and cognition questionnaires.

Surgery of Subclinical Cortisol Secreting Adrenal Incidentalomas

Treatment response will defined as a reduction of at least 1 step of SAHR at the end of the study, with BP maintained within the study objectives (\<135 mm Hg systolic and \<85 mm Hg diastolic) according to self-measurement at home.

age, family history of hypertension, duration of hypertension, kidney function, biochemical endocrine abnormalities, urinary steroid profile

Comparison of the two therapeutic strategies with regard to cardiovascular risk factors/markers: BMI, body composition evaluated by DEXA, abdominal fat evaluated on CT-scan, fasting blood glucose and insulin, HbA1C, HOMA-IR (homeostasis model of assessment of insulin resistance) and OGTT (oral glucose tolerance test), blood lipids, pro-inflammatory adipokines

Comparison of the two therapeutic strategies with regard to quality of life

University Hospital, Bordeaux

Respiratory Tract (Lung and Bronchial) Diseases

Substance Related Disorders

Wounds and Injuries

Lung Neoplasms

Cardiotoxicity

Respiratory Tract Neoplasms

Thoracic Neoplasms

Lung Diseases

Respiratory Tract Diseases

Heart Diseases

Drug-Related Side Effects and Adverse Reactions

Chemically-Induced Disorders

Radiation Injuries

Immunomodulating Agents

Patients with locally advanced non-small cell lung cancer

Patients will be treated with definitive concurrent chemoradiation with curative intent as determined by their medical and radiation oncologists. We will consider timing of initiation and discontinuation, type, and cumulative dose of platinum based chemotherapy. We will also consider dose, duration, and type of immunotherapy. Radiation therapy will be delivered via proton or proton therapy. Our primary radiation therapy dose-volume exposures are whole heart volumetric dose. As secondary exposures, we will comprehensively define radiation therapy dose parameters to the right ventricle, entire left ventricle, left ventricle segments, coronary arteries, and mean heart dose.

Chemoradiation

Bonnie Ky, MD, MSCE

This observational cohort will evaluate the cardiovascular effects of chemoradiation used to treat locally advanced, non-small cell lung cancer. Patients will be enrolled prior to the start of therapy and followed during and for at least 2 years after therapy with echocardiograms, nuclear stress tests, blood sampling, and quality of life surveys.

Lung cancer is both the most common malignancy worldwide and the leading cause of cancer death in the US. While radiation therapy is highly effective for many solid tumors, thoracic radiation therapy carries a risk of cardiovascular morbidity and mortality that limits critical gains in cancer control and survival. The investigators will perform detailed cardiovascular phenotyping using biologic and imaging markers to define functional and physiologic perturbations that occur with radiation therapy. The study will provide insights into how cardiovascular risk factors and disease impact these biologic and functional changes. The investigators will also determine which radiotherapy dose-volume metrics are indicative of subclinical cardiotoxicity.

Plasma, Serum, and Buffy coat will be collected for planned biomarker analysis. Patients may optionally consent to have remaining blood banked for future analysis.

Cardiotoxicity in Locally Advanced Lung Cancer Patients Treated With Chemoradiation Therapy

Cardiotoxicity in Locally Advanced Lung Cancer Patients Treated With Chemoradiation Therapy: A Prospective Longitudinal Cohort

Participants may opt in to allowing data and/or banked samples to be used for future research and shared with other researchers. A detailed plan for sharing IPD will be finalized at a later date, and may depend in part on how many participants elect this option. Additional supporting information may be shared, including the study protocol and informed consent form.

All Cause Mortality assessed by National Death Index Search performed 5 years after the last patient is enrolled.

Cardiovascular Specific Mortality by National Death Index Search performed approximately 5 years after the final patient is enrolled.

Incidence of 5-Year MCE by EMR review and patient interview

Incidence of symptomatic adverse events as assessed by NCI's PRO-CTCAE

Change in echo-derived measures of LV peak systolic strain (longitudinal) from baseline

Change in echo-derived measures of ventricular-arterial coupling (Ea/Ees) from baseline

Change in PET/CT derived CFR from baseline

All-cause mortality assessed by electronic medical record (EMR) review

Cardiovascular specific mortality assessed by EMR review

Incidence of MCE assessed by EMR review and patient interview

Change in echo-derived LVEF from baseline

Change in echo-derived RV longitudinal strain from baseline

Change in echo-derived circumferential strain from baseline

Change in echo-derived measures of diastolic function from baseline

Change in echo-derived measures of valvular disease (degree of regurgitation or stenosis) from baseline

Change in 3D echocardiography derived LVEF from baseline

Change in 3D echocardiography derived measures of LV systolic strain from baseline

Change in 3D echocardiography derived measures of LV twist and torsion from baseline

Change in PET/CT derived measures of global and regional myocardial blood flow at rest from baseline

Change in PET/CT derived measures of global and regional myocardial blood flow at stress from baseline

Change in FACIT Fatigue score from baseline. Score ranges from 0-52. Higher scores indicated less fatigue.

Change in FACIT Dyspnea score from baseline. Score ranges from 0-30. Higher scores indicate more dyspnea.

Change in Godin Leisure Time Exercise Score from baseline. Higher scores indicate higher levels of physical activity.

Abramson Cancer Center at Penn Medicine

Vascular Diseases

Fatigue

Insulin Resistance

Hyperinsulinism

Metabolic Diseases

Glucose Metabolism Disorders

This group will start with a physical activity program 3 months before the end of their chemotherapeutic regimen. After chemotherapy they will continue the PA program for another 3 months.

This group will start with a physical activity program after the end of their chemotherapeutic regimen. The physical activity program wil take 6 months to complete.

The early group will start the PA program during chemotherapy for 3 months, and after completion of chemotherapy for 3 months (total 6 months). The PA program will consist of two components: improvement of physical fitness and empowerment to adopt a healthy lifestyle. Longitudinal effects of this PA program will be evaluated at 5 time points: before chemotherapy; at start of the PA program and at 3, 6 and 18 months after start of the PA program. Safety parameters will be monitored throughout the study period.

A tailored physical activity program during chemotherapy

The late group will start the PA program after completion of the chemotherapy for 6 months. The PA program will consist of two components: improvement of physical fitness and empowerment to adopt a healthy lifestyle. Longitudinal effects of this PA program will be evaluated at 5 time points: before chemotherapy; at start of the PA program and at 3, 6 and 18 months after start of the PA program. Safety parameters will be monitored throughout the study period.

A tailored physical activity program after chemotherapy

Annemiek Walenkamp, PhD

The number of long-term cancer survivors is growing. As a result, treatment-related morbidity - such as cardiovascular disease, metabolic syndrome, functional decline and fatigue - is impacting quality of life and impairing survival. Metabolic syndrome in the general population is currently treated with lifestyle advice to increase physical activity (PA) and reduce caloric intake. This approach is still underused as standard care for cancer survivors. The aim of this study is investigate whether a tailored PA program that starts early (during curative chemotherapy with cardiovascular toxic potential) is superior in terms of reducing long-term cancer-treatment-related metabolic syndrome and cardiovascular morbidity to a program that starts late (after completion of chemotherapy).

Improved treatment is partly responsible for the increased survival and life expectancy in cancer patients. However, such treatment can be harmful as well, and cancer survivors therefore, face an increased risk of second malignancies and other chronic diseases, e.g. cardiovascular diseases and metabolic syndrome.

Due to the growing number of cancer patients and survivors, attention for rehabilitation, especially physical training, is growing. Several meta-analyses show the beneficial effects of physical training on several outcomes such as physical fitness, muscle strength, fatigue and quality of life, and a few studies showed the effect of exercise on physical active behaviour. However, studies on the effect of timing of exercise are lacking.

The present study aims to insert a tailored physical activity program early versus late in the chemotherapy based cancer treatment and will yield data about its safety and efficacy. We hypothesize that a tailored physical activity program during early cancer treatment may more be effective to reduce long-term cancer treatment toxicities and morbidity in cancer survivors compared to a program after cancer treatment.

Primary Objective: To investigate whether a tailored physical activity program that starts during chemotherapy (early) is superior in terms of physical fitness, as determined by VO2 peak at one year, to a program that starts after completion of chemotherapy (late).

Secondary Objectives: To examine the effect of the physical activity program on muscle strength and activity level, change in metabolic and cardiovascular damage parameters, cardiovascular risk factors and quality of life including self-efficacy, motivation for exercise, and fatigue.

Design: This protocol describes a multicenter, randomized study with 2 arms. Patients who will be treated with curative systemic chemotherapeutic treatment for testicular cancer, early colon cancer, early breast cancer or B-NHL will be randomized into an early or late PA program group. The early group will start the PA program during chemotherapy (for 12 weeks) until 12 weeks after completion of chemotherapy (total 24 weeks of training). The late group will start the same program (total of 12 weeks) after completion of chemotherapy. The longitudinal effects of the physical activity (PA) program for all participants will be evaluated at different time points in the UMCG: before start of chemotherapeutic treatment; at the start of the PA program and at 3, 6, 18 months after starting the PA program and 18 months after the last chemotherapy.

Optimal Timing of Physical Activity in Cancer Treatment

Optimal Timing of a Tailored Physical Activity Program During Chemotherapeutic Cancer Treatment to Reduce Long-term Cardiovascular Morbidity

The aim of this study is investigate whether a tailored PA program that starts early (during curative chemotherapy with cardiovascular toxic potential) is superior in terms of reducing long-term cancer-treatment-related metabolic syndrome and cardiovascular morbidity to a program that starts late (after completion of chemotherapy).

The VO2 at the peak of the exercise will be defined as peak oxygen uptake (VO2 peak), measured by cardiopulmonary exercise testing (CPET) on a stationary bicycle ergometer. The CPET is considered to be the most precise measure of cardio-respiratory fitness and is recommended for use in order to determine a patient's objective or subjective difference in exercise capacity

Maximal voluntary isometric muscle force of the right and left extremity of extension of the knee, flexion of the knee, flexion of the elbow and extension of the elbow will be measured using a hand-held dynamometer. The "break method" will be used for all measurements. To employ this technique, the examiner gradually overcomes the force exerted by the patient until the extremity gives way. All measurements will be performed at least three times, with recovery intervals of at least 10 seconds. The peak forces (in Newtons) will be recorded and mean values of three technically correct measurements will be taken for analysis.

Vascular damage will be determined with the intima-media thickness (IMT) of the common carotid artery and femoral artery, performed with an Ultrasound technique.

BMI (body mass index): weight in kilograms divided by height in meters squared

Quality of life will be measured with the European Organization for Research and Treatment of Cancer (EORTC), Quality of Life Questionnaire Core 30 (QLQ-C30) version 3.0 questionnaire

Patient reported general self-efficacy, measuring the patients' expectations of their general capacities, will be evaluated using the Dutch version of the General Self-Efficacy Scale (GSES), the "Algemene Competentie Schaal" (ALCOS)

The Multi-dimensional Fatigue Inventory is a validated 20-item questionnaire on different domains of fatigue

Physical activity will be assessed with the Sum score of the Physical Activity Scale for the Elderly questionnaire (PASE). This questionnaire consists of questions on leisure time, household and work-related activities.

Whole blood will be drawn of patients and collected in EDTA tubes. DNA isolations and the Global Screening Array will be performed at the Human Genomics Facility (HuGeF) of the Genetic Laboratory of the Department of Internal Medicine at Erasmus MC, Rotterdam, the Netherlands

Senescence will be measured in a subset of testicular cancer patients.

Markers of scenescence will be obtained from a skin biopsy and fat biopsy. Also, additional blood samples will be assessed to establish markers of the senescence- associated secretory phenotype.

Cardiac function will be measured at baseline and at the final measurement (e.g. left ventricular ejection fraction)

With the DEXA scan, measurements of body composition will be obtained.

Endothelial activation will be determined with PAI antigen in blood serum, in ug/L

Endothelial activation will be determined with t-PA antigen in blood serum, in ug/L

Endothelial activation will be determined with factor VIII in blood serum, in %

Endothelial activation will be determined with von Willebrand facor in blood serum, in %

Endothelial activation will be determined with fibrinogen in blood serum, in g/L

Advanced glycation end products will be measured with an AGEreader

Systolic and diastolic blood pressure in mmHg

Skinfold measurement of biceps, triceps, sub scapula and supra iliaca

University Medical Center Groningen

1. Baseline consultation with physiatrist specialized in CRP - addressing CVRF control, comorbidities and disabilities; case-by-case discussion with a cardiologist specialized in CR will be undertaken, for tailoring exercise prescription. Nutritional individualized plan addressing dietary goals. Psychological management addressing psychosocial outcomes and motivation for healthy lifestyle habits
2. Multidisciplinary team educational meeting: periodic group sessions with health education purposes
3. Exercise intervention - 2 times/week sessions at CR facilities, supervised by a physiatrist, conducted by physiotherapist. Heart rate (HR) continuously monitored during each session by remote electrocardiographic monitoring or HR monitor. Exercise intensity estimated according to CR guidelines, determined after CV risk stratification, using CPET results.

a) Besides standard medical and supportive care, psychological and nutritional individual support will be offered on demand, in hospital setting, according to the attending physician standard clinical assessment and usual care.

Exercise intervention - Performed at a community-based facility, comprising 2 sessions/week, prescribed according to current physical activity guidelines for cancer survivors. Exercise intervention will be conducted by an exercise physiologist, internationally certified in exercise for cancer patients

In addition to standard medical care, for an 8-week period, patients will have access to the core components of a CRP, delivered by a multidisciplinary rehabilitation team

Cardiac Rehabilitation Program

In addition to standard medical care, for an 8-week period, patients will have access to a community exercise intervention oriented by a sports professional

Community exercise intervention

Many cancer survivors are at risk for cardiovascular disease (CVD); it is therefore important to identify patients at increased risk for cardiotoxicity, especially in the setting of CVRF or pre-existing CVD, and to design personalized interventions to prevent cardiovascular morbidity. In this background, cardio-oncology rehabilitation frameworks for specific cancer patients have been proposed. Given potential beneficial effects of exercise among cancer patients (including those at higher risk of CVD), data pertaining to optimal program designs are of paramount contemporary importance.

Thus, the aim of this study is to compare the impact of a Cardiac Rehabilitation Program (CRP) model versus a community-based exercise intervention plus usual care on cardiorespiratory fitness (CRF), physical function domains and CVRF control in adult cancer survivors who have been exposed to cardiotoxic cancer treatment and/or with cardiovascular medical background. Study outcomes will be assessed at baseline (M0) and after an 8 weeks-intervention (M1), comprising maximal aerobic capacity (peak oxygen uptake), muscular strength, neuromuscular function, single CVRF control including physical activity measurements and psychosocial parameters, health-related quality of life, fatigue, health literacy, inflammatory response and feasibility metrics; an economic evaluation will provide quantitative comparison, for a cost-effectiveness analysis

Impact of a Comprehensive Cardiac Rehabilitation Program Framework Among High Cardiovascular Risk Cancer Survivors

minute ventilation to carbon dioxide production slope (VE/VCO2 slope) assessed by CPET

muscle strength measured with manual dynamometers (Kgf)

Changes in body composition assessed by bioelectrical impedance analysis

Measured with an average of 3 readings by an automated measurement device as per the ESC guidelines (mmHg)

Measured with an average of 3 readings by an automated measurement device (bpm)

Measured through fasting Blood biochemistry including total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), triglycerides (TG)

Measured through glycated haemoglobin (%) in fasting state

Self-reported through the International Physical Activity Questionnaire, classifying the activity in three categories (low activity levels, moderate activity levels or high activity levels)

objectively assessed by accelerometer, to wear for seven consecutive days

Cigarette smoking habits quantified in pack-year and cigarettes per day, to measure exposure to tobacco

Psychosocial parameters assessed through the Hospital Anxiety and Depression Score questionnaire. Scores 0-14. A sub-scale score \> 8 denotes anxiety or depression symptoms

Evaluated using the EuroQuol Five- Dimensional questionnaire ( EQ-5D-5L). It consists in five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state. The EQ - Visual Analog Scale records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.

Fatigue score evaluated by the specific item on the EORTC QLQ-C30 questionnaire (high score representing high level of symptomatology)

Assessed by the Newest Vital Sign questionnaire; range score 0-6 (high score corresponding to high health literacy)

Blood samples collected to access plasma levels of IL-6

Blood samples collected to access plasma levels of high-sensitivity C-reactive protein

number of patients who met inclusion criteria divided by the number who consented in writing to participate. Reasons for not participating in the study will be registered.

all the events will be recorded and registered as "related" or "unrelated" to the intervention itself, as well as the impact for exercise concerns or other health intervention required

number of participants who remained in the study (without formally drop out during intervention).

total number of exercise sessions attended by participants allocated to this intervention group. Reasons for dropping out will be registered.

number of patients that completed all the evaluations during the defined timeline.

Incremental cost per quality-adjusted life. Costs will be calculated from the provider perspective, which includes the costs incurred by the health institution providing health services; and from the societal perspective

Centro Hospitalar de Vila Nova de Gaia/Espinho, E.P.E.

University Institute of Maia

Associacao de Investigacao de Cuidados de Suporte em Oncologia

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Testicular Neoplasms

Genital Neoplasms, Male

Urogenital Neoplasms

Genital Diseases

Genital Diseases, Male

Urogenital Diseases

Male Urogenital Diseases

Testicular Diseases

Gonadal Disorders

Elisabeth G.E. de Vries, MD, PhD

BACKGROUND:

Evidence has emerged that patients cured with cisplatin-bleomycin chemotherapy from disseminated testicular cancer (TC) develop a large number of cardiovascular risk factors (CRF) several years later. Recently, we observed an increased incidence of cardiac events 10-20 years after chemotherapy, possibly as a result of increased occurrence of CRF. Additional cardiovascular damage was observed after treatment: disturbed diastolic function of the left ventricle, microalbuminuria and increased endothelial damage parameters. Furthermore, a metabolic syndrome (syndrome X) with insulin-resistance, dyslipidemia, hypertension and endothelial damage was found in about one third of our cured patients. The investigators hypothesize that endothelial damage and metabolic changes caused by the bleomycin and cisplatin chemotherapy are the main causes for the observed increase in cardiovascular disease in these young cancer survivors. Genetic susceptibility may be an important determinant of individual risk of toxicity in individual patients.

PURPOSE:

1. To identify risk factors for cardiovascular disease (CVD) following testicular cancer.
2. To obtain insight into the pathway(s) of CVD development, by examining whether clinical CVD following testicular cancer is associated with a preceding unfavorable cardiovascular risk factor profile and/or with treatment-related factors.
3. To investigate genetic polymorphisms in pathogenetically important pathways that are potentially involved in the development of treatment related cardiovascular morbidity following testicular cancer.

PATIENTS AND METHODS:

Patients with non-seminomatous testicular cancer who have been uniformly treated with orchidectomy and cisplatin-bleomycin combination chemotherapy at the University Hospital Groningen, The Netherlands, since 1977 but before 2000 are eligible. 380 patients with non-seminomatous testicular cancer fulfill these criteria. A close routine follow-up of these patients after treatment has been done at the University Hospital Groningen. Clinical characteristics of these patients, treatment details including outcome and long-term follow-up are being registered systematically. From all patients who agree to participate assessment of their cardiovascular risk factors and the presence of subclinical cardiovascular damage will be performed by means of several measurement techniques. Also genomic DNA will be collected for studies on polymorphisms in pathogenetically important pathways. For the total cohort of patients several different late effects phenotypes of cardiovascular damage and cardiovascular risk factor patterns will be derived from the available data. These toxicity phenotypes will be used to select cases and controls from the total cohort to test candidate genetic polymorphisms on their association with occurrence of toxicity. The association of the different genetic polymorphisms with the toxicity phenotype will be estimated by comparing cases with different toxicity phenotypes with controls without that phenotype.

POSSIBLE RESULTS This research will provide insight into the pathogenesis of cardiovascular disease after treatment for testicular cancer. The main outcome will be the possibility to select individually those patients who are likely to have an increased risk to encounter specific cardiovascular toxicity during or after chemotherapy treatment for TC. This will provide opportunities for the tailoring of potential toxic treatment and/or guide primary and secondary prevention strategies for serious side effects of chemotherapy treatment.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Surgery of Subclinical Cortisol Secreting Adrenal Incidentalomas	NCT02364089	Adrenal Inciden...	Laparoscopic su... Standardized me...	18 Years - 80 Years	University Hospital, Bordeaux
Cardiotoxicity in Locally Advanced Lung Cancer Patients Treated With Chemoradiation Therapy	NCT04305613	Cardiotoxicity Lung Cancer Sta... Lung Cancer Sta... Radiation Toxic...	Chemoradiation	18 Years -	Abramson Cancer Center at Penn Medicine
Optimal Timing of Physical Activity in Cancer Treatment	NCT01642680	Metabolic Syndr... Vascular Disord... Cardiovascular ... Fatigue	A tailored phys... A tailored phys...	18 Years - 80 Years	University Medical Center Groningen
Optimal Timing of Physical Activity in Cancer Treatment	NCT01642680	Metabolic Syndr... Vascular Disord... Cardiovascular ... Fatigue	A tailored phys... A tailored phys...	18 Years - 80 Years	University Medical Center Groningen
Surgery of Subclinical Cortisol Secreting Adrenal Incidentalomas	NCT02364089	Adrenal Inciden...	Laparoscopic su... Standardized me...	18 Years - 80 Years	University Hospital, Bordeaux
Impact of a Comprehensive Cardiac Rehabilitation Program Framework Among High Cardiovascular Risk Cancer Survivors	NCT05132998	Oncologic Disor... Cardiovascular ...	Cardiac Rehabil... Community exerc...	18 Years -	Associacao de Investigacao de Cuidados de Suporte em Oncologia
Cardiovascular Morbidity in Testicular Cancer Survivors: Study of Risk Factors and Assessment of Pharmacogenomic Determinants of Toxicity	NCT00161174	Non-seminomatou...		-	University Medical Center Groningen
Cardiac Function and Cardiovascular Risk Profile in Testicular Cancer Patients	NCT00705094	Testicular Canc... Seminoma Non-seminomatou...		18 Years -	AHS Cancer Control Alberta
Evaluation of Endocrine and Metabolic Parameters in the New Diagnostic Phenotypes of Polycystic Ovary Syndrome	NCT00784615	Polycystic Ovar...	Blood samples, ...	18 Years - 35 Years	Universidad Nacional de Córdoba
Cardiotoxicity in Locally Advanced Lung Cancer Patients Treated With Chemoradiation Therapy	NCT04305613	Cardiotoxicity Lung Cancer Sta... Lung Cancer Sta... Radiation Toxic...	Chemoradiation	18 Years -	Abramson Cancer Center at Penn Medicine

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