Reply: Cisplatin-associated aortic thrombosis: a review of cases reported to the FDA adverse event reporting system

We are grateful to Dr. Nguyen and colleagues for their interest in our recent study (1), published in JACC: CardioOncology, that assessed the vascular effects of cisplatin-based chemotherapy in patients with testicular cancer. We read with interest their work that highlights 37 cases of aortic thrombosis associated with cisplatin in the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System and in medical publications. Their data are important in further demonstrating the potential for these clinically serious adverse thrombotic effects of cisplatin-based chemotherapy. In that study, of the 37 patients studied, aortic thrombosis was associated with a serious clinical outcome in all patients, with 1 patient requiring limb amputation. There were also 4 deaths. The total number of patients treated with cisplatin during the period studied is not available from this adverse event reporting system. However, the data clearly highlight that the beneficial anticancer effects of cisplatin-based chemotherapy (2,3) can come at the cost of an increased risk of serious and potentially fatal adverse cardiovascular effects.