# Rechallenge With Cisplatin After an Acute Coronary Event

## TL;DR

A young man with testicular cancer safely resumed cisplatin treatment after a heart-related complication with careful monitoring and team coordination.

## Contribution

This case demonstrates that cisplatin rechallenge is feasible after an acute coronary event with multidisciplinary care.

## Key findings

- Cisplatin-induced myocardial infarction can resolve with antiplatelet and anticoagulant therapy.
- Multidisciplinary evaluation enables safe cisplatin rechallenge in select patients.
- Close surveillance and optimized medical management are critical for successful rechallenge.

## Abstract

Testicular cancer is the most common malignancy in young men, and cisplatin-based chemotherapy provides excellent long-term survival. However, cisplatin-associated cardiovascular toxicity spans a broad spectrum, and evidence guiding rechallenge after an acute coronary event is limited.

A 24-year-old man with testicular cancer and no cardiovascular risk factors developed chest pain and elevated troponins early in his cisplatin therapy. Coronary angiography revealed a nonocclusive left anterior descending artery thrombus. After treatment with antiplatelet and anticoagulant therapy, the thrombus resolved, and he subsequently underwent a carefully monitored cisplatin rechallenge.

Given cisplatin's curative benefit, a multidisciplinary team—including cardiology, oncology, and pharmacy—assessed the risks and benefits of continuing therapy. With close surveillance and optimized medical management, including anti-ischemic therapy and anticoagulation, cisplatin was safely reintroduced.

Cisplatin-induced myocardial infarction requires prompt recognition and coordinated care. With multidisciplinary evaluation, rechallenge can be safely performed in select patients.