An update on the risk prediction and prevention of anticancer therapy-induced cardiotoxicity

Bhave, Manali; Shah, Ami N.; Akhter, Nausheen; Rosen, Steven T.

doi:10.1097/cco.0000000000000132

Cited by 12 publications

(17 citation statements)

References 64 publications

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“…age, previous CVD, and chemotherapy or radiotherapy regime [11][12][13]. The aim of this study was to produce a standardised, comprehensive approach to assessing the risk of cardiotoxicity, which included assessment and measurement of CVD risk and lifestyle factors that may indicate undiagnosed CVD prior to cancer treatment.…”

Section: Discussionmentioning

confidence: 99%

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Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment

et al. 2017

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Background: Cardiotoxicity from anticancer therapy affects heart function and structure. Cardiotoxicity can also lead to accelerated development of chronic diseases, especially in the presence of risk factors. Methods: This study aimed to develop and pilot a combined cardiovascular disease and cardiotoxicity risk assessment questionnaire to quantify the potential extent of risk factors in breast cancer patients prior to treatment. The questionnaire underwent content and face validity evaluation by an expert panel followed by pilot testing in a sample of breast cancer patients (n = 36). Questionnaires were self-administered while attending chemotherapy clinic, in the presence of a research assistant. Results: Mean age of participants was 54.8 years (range 36-72 years). Participants reported CVD risk factors including diabetes 2.8%, hypertension 19.8%, hypercholesterolaemia 11% and sleep apnoea 5%. Lifestyle risk factors, included not eating the recommended serves of vegetables (100%) or fruit (78%) per day; smoking (13%) and regularly consuming alcohol (75%). Twenty five percent reported being physically inactive, 61%, overweight or obese, 24%, little or no social support and 30% recorded high to very high psychological distress. Participants were highly (75%) reluctant to undertake lifestyle changes; i.e. changing alcohol consumption; dietary habits; good emotional/mental health strategies; improving physical activity; quitting smoking; learning about heart-health and weight loss. Conclusion: This study is an important step towards prevention and management of treatment-associated cardiotoxicity after breast cancer diagnosis. We recommend that our questionnaire is providing important data that should be included in cancer registries so that researchers can establish the relationship between CVD risk profile and cardiotoxicity outcomes and that this study revealed important teaching opportunities that could be used to examine the impact on health literacy and help patients better understand the consequences of cancer treatment.

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Section: Discussionmentioning

confidence: 99%

“…Previous cardiotoxicity assessment tools have focused only on the factors with established causality (e.g. age, previous CVD, and chemotherapy or radiotherapy regime) [11][12][13]; however, currently there is no questionnaire that enables such a comprehensive CVD risk profile assessment specific to breast, or any other, cancer care [14].…”

Section: Introductionmentioning

confidence: 99%

Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment

et al. 2017

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“…This association has already been reported,14 as insulin resistance is associated with HF 15. Arterial hypertension has previously been identified as one of the main factors for ADRC 16, 17. The rate of previous cardiac disease was 6.3%, another finding, which confirms previous investigations 16.…”

Section: Discussionmentioning

confidence: 99%

“…Arterial hypertension has previously been identified as one of the main factors for ADRC 16, 17. The rate of previous cardiac disease was 6.3%, another finding, which confirms previous investigations 16. The increasing number of the COT study population might influence the determinants of ADRC because of factors such as age, previous cardiac irradiation, and especially coronary artery disease.…”

Section: Discussionmentioning

confidence: 99%

Protocol update and preliminary results of EACVI/HFA Cardiac Oncology Toxicity (COT) Registry of the European Society of Cardiology

et al. 2017

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AimsEuropean Association of Cardiovascular Imaging/Heart Failure Association Cardiac Oncology Toxicity Registry was launched in October 2014 as a European Society of Cardiology multicentre registry of breast cancer patients referred to imaging laboratories for routine surveillance, suspected, or confirmed anticancer drug‐related cardiotoxicity (ADRC). After a pilot phase (1 year recruitment and 1 year follow‐up), some changes have been made to the protocol (version 1.0) and electronic case report form.Methods and resultsMain changes of the version 2.0 concerned exclusion criteria, registry duration, and clarification of the population characteristics. Breast cancer radiotherapy has been removed as an exclusion criterion, which involves now only history of a pre‐chemotherapy left ventricular dysfunction. The period for long‐term registry recruitment has been reduced (December 2017), but the target study population was extended to 3000 patients. The characteristics of the population are now better defined: patients seen in an imaging lab, which will include patients undergoing chemotherapy with associated targeted therapy or no targeted therapy, at increased risk of ADRC. In total, 1294 breast cancer patients have been enrolled, and 783 case report forms locked from October 2014 to November 2016. Of these, 481 (61.4%) were seen at first evaluation and 302 (38.6%) while on oncologic treatment with anticancer drugs. Fifty‐two patients (17.2%) were not in targeted therapies, 191 (63.3%) were ongoing targeted therapy, and 59 (19.5%) had completed it. Twenty‐three (2.9%) patients had a suspected diagnosis and 35 (4.5%) a confirmed diagnosis of ADRC. Arterial hypertension was the most prevalent cardiovascular risk factor (29.2%) followed by diabetes (6.1%). Previous history of heart failure accounted for 0.5%, whereas previous cardiac disease was identified in 6.3% of population.ConclusionThe changes of the original protocol of the COT Registry and first update allow a first glance to the panorama of cardiovascular characteristics of breast cancer patients enrolled.

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“…2 Animal studies have investigated alternative approaches such as exercise, 3 dietary antioxidants, 4,5 lipid-lowering drugs, 6 and topoisomerase II inhibitors 7 to reduce cell damage caused by Dox. Its major drawback is a delayed cardiomyopathy which limits the cumulative dose given.…”

Section: Introductionmentioning

confidence: 99%

Differential toxicity of gold-doxorubicin in cancer cells vs. cardiomyocytes as measured by real-time growth assays and fluorescence lifetime imaging microscopy (FLIM)

Tawagi

Massmann

Chibli

et al. 2015

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An update on the risk prediction and prevention of anticancer therapy-induced cardiotoxicity

Cited by 12 publications

References 64 publications

Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment

Cardiotoxicity and cardiovascular disease risk assessment for patients receiving breast cancer treatment

Protocol update and preliminary results of EACVI/HFA Cardiac Oncology Toxicity (COT) Registry of the European Society of Cardiology

Differential toxicity of gold-doxorubicin in cancer cells vs. cardiomyocytes as measured by real-time growth assays and fluorescence lifetime imaging microscopy (FLIM)

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