Cardiooncology—dealing with modern drug treatment, long-term complications, and cancer survivorship

Abstract

Modern treatment strategies have improved prognosis and survival of patients with malignant diseases. The key components of tumor treatment are conventional chemotherapy, radiotherapy, targeted therapies, and immunotherapy. Cardiovascular side-effects may occur in the early phase of tumor therapy or even decades later. Therefore, knowledge and awareness of acute and long-lasting cardiac side effects of anti-cancer therapies are essential. Cardiotoxicity impairs quality of life and overall survival. The new cardiologic subspecialty ‘cardio-oncology’ deals with the different cardiovascular problems arising from tumor treatment and the relationship between cancer and heart diseases. Early detection and treatment of cardiotoxicity is of crucial importance. A detailed cardiac assessment of patients prior to administration of cardiotoxic agents, during and after treatment should be performed in all patients. The current review focusses on acute and long-term cardiotoxic side effects of classical cytotoxic and selected modern drug treatments such as immune checkpoint inhibitors and discusses strategies for the diagnosis of treatment-related adverse cardiovascular effects in cancer patients.

Immune Checkpoint Inhibitor Associated Myocarditis and Cardiomyopathy: A Translational Review

“…Therefore, more studies are required to determine the precise frequency of ICI-mediated cardiotoxicity. By extending clinical data surveillance, diagnostic and therapeutic strategies can be sharpened [ 137 ]. Recently, the ESC published the first cardio-oncology guideline, including the management of patients under ICI treatment.…”

Cardiotoxicity of antineoplastic therapy: Underlying mechanisms, clinical manifestations, and basic principles of cardio-oncology

“…Antineoplastična terapija može da dovede do ireverzibilnog oštećenja miokarda (Tip I), ili do disfunkcije kardiomiocita, tj. reverzibilnog oštećenja miokarda (Tip II) [17]. Ireverziblno oštećenje miokarda najčešće izazivaju antraciklini, dok je reverzibilno oštećenje miokarda karakteristika HER-2 (engl.…”

“…Antineoplastic therapy can lead to irreversible damage to the myocardium (Type I), or to cardiomyocyte dysfunction, i.e., reversible myocardial damage (Type II) [17]. Irreversible myocardial damage is most often caused by anthracyclines, while reversible myocardial damage is a characteristic of HER-2 (human epidermal growth factor receptor 2) and VEGFR (vascular endothelial growth factor receptor) inhibitors, as well as of BCR-ABL tyrosine kinase inhibitors [18].…”

Factors influencing physicians’ decision to conduct cardiovascular risk assessments among cancer patients: A Systematic Review

“…Cancer therapy-related cardiac dysfunction (CTRCD) usually occurs in the rst year after cancer diagnosis, while the risks remain elevated throughout the follow-up time [1]. For this reason, the goals of developing the cardio-oncology discipline came with two main intentions: 1) to provide the best cancer therapies available with minimal impact on CV health and; 2) to conduct CV surveillance throughout the spectrum of cancer therapies [9]. Despite recognition of these complications, incorporation of cardiovascular risk assessment as part of routine clinical practice remains a challenge.…”