Cardio‐oncology discipline: focus on the necessities in developing countries

Alizadehasl, Azin; Amin, Ahmad; Maleki, Majid; Noohi, Feridoun; Ghavamzadeh, Ardeshir; Farrashi, Melody

doi:10.1002/ehf2.12838

Cited by 9 publications

(6 citation statements)

References 42 publications

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“…Similar findings have been reported in the setting of adjuvant therapy [18,19]. Accordingly, the clinical benefits of trastuzumab in BC treatment have been overshadowed by the emerging cardiovascular sequels [20][21][22].…”

Section: Introductionsupporting

confidence: 70%

Potential Ameliorating Role of Spironolactone in Trastuzumab-induced Cardiotoxicity: A Narrative Review

Ghabousian

Alizadehasl²,

Ansari³

et al. 2022

IJMTFM

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Background: Around 20% of breast cancers (BCs) overexpress Human Epidermal Growth Factor Receptor 2 (HER-2). HER-2 overexpression is associated with increased tumor aggressiveness and poor prognosis. Trastuzumab (an anti-HER2 monoclonal antibody) has been reported to improve overall survival in early-stage and metastatic BCs, but at the expense of increasing cardiac morbidity. In the current review study, we aims to discuss the pathogenesis of trastuzumab-induced cardiotoxicity and the potential ameliorating role of spironolactone in this regard. Methods: The search strategy aimed to identify both published and unpublished studies. First off, we identified keywords and index terms, including trastuzumab, cardiotoxicity, heart failure, and spironolactone to conduct a broad search in PubMed, Embase, Scopus, and Web of Science, using the aforementioned keywords either individually or in combination. Lastly, the reference list of all identified articles was also evaluated. Our study included observational and interventional studies, case-reports, and systematic reviews and meta-analyses. Results: Trastuzumab could deteriorate mitochondrial function and subsequently leads to the accumulation of Reactive Oxygen Species (ROS) in cardiomyocytes. Published clinical studies offered conflicting results regarding the efficacy of angiotensin-converting enzyme inhibitors and beta-blockers in respect of trastuzumab-induced cardiotoxicity. On the other hand, spironolactone was found to have both antioxidant and anti-inflammatory properties. Recent in-vivo studies supported the cardioprotective effect of spironolactone through maintaining mitochondrial ultrastructure and reducing ROS production. Conclusion: Although spironolactone mitigates oxidative stress and mitochondrial dysfunction, there is a lack of clinical evidence to support the effectiveness of spironolactone in trastuzumab-induced cardiotoxicity. Design and implementation of clinical trials are recommended to determine the potential beneficial effects of spironolactone on trastuzumab-induced cardiotoxicity.

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Section: Introductionsupporting

confidence: 70%

Potential Ameliorating Role of Spironolactone in Trastuzumab-induced Cardiotoxicity: A Narrative Review

Ghabousian

Alizadehasl²,

Ansari³

et al. 2022

IJMTFM

Self Cite

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“…Similarly, population-based cancer registries from the early 1980s suggest a potential increase in incident cases among males and females by 2021 [12]. This co-occurrence of cardiovascular disease (CVD) and cancer is driven by improved survival rates and shared risk factors such as smoking, hyperlipidemia, and obesity, leading to similar mortality patterns among patients [13]. In developing countries, diagnostic and therapeutic processes differ substantially from those in developed nations due to limited budgets and infrastructure.…”

Section: A Classic Cardio-oncology Setup In Lmicmentioning

confidence: 99%

Cardio-Oncology: The Need of the Hour Subspeciality

Dhal

2024

WJCD

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There have been considerable advancements in cancer therapy in recent years. However, adverse effects often defeat the benefits, especially on the cardiovascular system. The effects of chemotherapeutic agents on the cardiovascular system can be directly on the heart by altering the coagulability state or by altering the hemodynamic system. Some drugs like Sunitinib and Bevacizumab show Heart Failure which is chemotherapy-induced. Other agents are notorious for showing QT prolongation like Vandetanib. Similarly, other agents with demonstrated cardiotoxicity would be molecular-targeted drugs (Trastuzumab and Pertuzumab) and cytostatic agents (Anthracycline How to cite this paper: Dhal, A.

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“…1,2 This relationship includes the cardiotoxicity associated to cancer therapies. 3 Cancer therapy-related cardiac dysfunction (CTRCD) is recognized as one of the main causes of mortality among breast, prostate, and bladder cancer survivors, even surpassing the mortality related to recur-rence of the baseline malignancy, [3][4][5] and impact the prognosis of patients treated in the short and long term. 6 The cardiotoxic events include myocardial dysfunction, heart failure (HF), coronary artery disease, valvular disease, arrhythmias, pericardial disease, hypertension, and thrombolytic events, among others.…”

Section: Introductionmentioning

confidence: 99%

Novel molecular biomarkers of cancer therapy‐induced cardiotoxicity in adult population: a scoping review

et al. 2022

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Aim Cancer treatments are associated with cardiotoxic events that predispose to cardiac pathology and compromise the survival of patients, making necessary the identification of new molecular biomarkers to detect cardiotoxicity. This scoping review aims to identify the available evidence on novel molecular biomarkers associated with cardiotoxicity in the adult population undergoing cancer therapy. Methods and resultsThe databases Medline, Web of Science, Scopus, and Embase were screened for the identification of published studies until 23 August 2020, searching for novel molecular biomarkers reported in cancer therapy-related cardiac dysfunction in adult patients. A total of 42 studies that met the eligibility criteria were included. Fourteen studies reported 44 new protein biomarkers, 18 studies reported 57 new single nucleotide polymorphism biomarkers, and 11 studies reported 171 new gene expression profiles associated with cardiotoxicity. Data were extracted for 272 novel molecular biomarkers reported and evaluated in 7084 cancer patients, of which only 13 were identified in more than one study (MPO, sST2, GDF-15, TGF-B1, rs1056892, rs1883112, rs4673, rs13058338, rs1695, miR-1, miR-25-3p, miR-34a-5p, and miR-423-5p), showing values for area under the curve > 0.73 (range 0.74-0.85), odds ratio 0.26-7.17, and hazard ratio 1.28-1.80. Conclusions Multiple studies presented a significant number of novel molecular biomarkers as promising predictors for risk assessment of cardiac dysfunction related to cancer therapy, but the characteristics of the studies carried out and the determinations applied do not allow suggesting the clinical use of these molecular biomarkers in the assessment of cancer therapy-induced cardiotoxicity.

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Cardio‐oncology discipline: focus on the necessities in developing countries

Cited by 9 publications

References 42 publications

Potential Ameliorating Role of Spironolactone in Trastuzumab-induced Cardiotoxicity: A Narrative Review

Potential Ameliorating Role of Spironolactone in Trastuzumab-induced Cardiotoxicity: A Narrative Review

Cardio-Oncology: The Need of the Hour Subspeciality

Novel molecular biomarkers of cancer therapy‐induced cardiotoxicity in adult population: a scoping review

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