Purpose: Serum platinum is measurable for years after completion of cisplatin-based chemotherapy (CBC). We report the largest investigation of serum platinum levels to date of 1,010 testicular cancer survivors (TCS) assessed 1-35 years after CBC and evaluate genetic contributions to these levels. Experimental Design: Eligible TCS given 300 or 400 (±15) mg/m2 cisplatin underwent extensive audiometric testing, clinical examination, completed questionnaires, and had crude serum platinum levels measured. Associations between serum platinum and various risk factors and toxicities were assessed after fitting a biexponential model adjusted for follow-up time and cumulative cisplatin dose. A genome-wide association study (GWAS) was performed using the serum platinum residuals of the dose and time-adjusted model.Results: Serum platinum levels exceeded the reference range for approximately 31 years, with a strong inverse relationship with creatinine clearance at follow-up (age-adjusted P = 2.13 × 10-3). We observed a significant, positive association between residual platinum values and luteinizing hormone (age-adjusted P = 6.58 × 10-3). Patients with high residual platinum levels experienced greater Raynaud phenomenon than those with medium or low levels (age-adjusted ORhigh/low = 1.46; P = 0.04), as well as a higher likelihood of developing tinnitus (age-adjusted ORhigh/low = 1.68, P = 0.07). GWAS identified one single-nucleotide polymorphism (SNP) meeting genome-wide significance, rs1377817 (P = 4.6 × 10-8, a SNP intronic to MYH14).Conclusions: This study indicates that residual platinum values are correlated with several cisplatin-related toxicities. One genetic variant is associated with these levels.

Clinical cancer research : an official journal of the American Association for Cancer Research. 2019 Jul 11 [Epub ahead of print]

Matthew R Trendowski, Omar El-Charif, Mark J Ratain, Patrick Monahan, Zepeng Mu, Heather E Wheeler, Paul C Dinh, Darren R Feldman, Shirin Ardeshir-Rouhani-Fard, Robert J Hamilton, David J Vaughn, Chunkit Fung, Christian Kollmannsberger, Taisei Mushiroda, Michiaki Kubo, Robyn Hannigan, Frederick Strathmann, Lawrence H Einhorn, Sophie D Fossa, Lois B Travis, M Eileen Dolan

Department of Medicine, University of Chicago, Chicago, Illinois., Department of Medical Oncology, Indiana University, Indianapolis, Indiana., Departments of Biology and Computer Science, Loyola University Chicago, Chicago, Illinois., Department of Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York., Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada., Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania., J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York., Division of Medical Oncology, University of British Columbia, Vancouver, British Columbia, Canada., RIKEN Center for Integrative Medical Science, Yokohama, Japan., School for the Environment, University of Massachusetts Boston, Boston, Massachusetts., NMS Labs, Willow Grove, Pennsylvania., Department of Oncology, Oslo University Hospital, Radiumhospital, Oslo, Norway., Department of Medical Oncology, Indiana University, Indianapolis, Indiana. ., Department of Medicine, University of Chicago, Chicago, Illinois. .