Cardiotoxicity screening of long‐term, breast cancer survivors—The CAROLE (Cardiac‐Related Oncologic Late Effects) Study

Puckett, Lindsay; Saba, Shahryar G.; Henry, Sonia; Rosen, Stacey E.; Rooney, Elise; Filosa, Samaria; Gilbo, Philip; Pappas, Karalyn; Laxer, Alison; Eacobacci, Katherine; Kapyur, A.; Robeny, Justin; Musial, Samantha; Chaudhry, Anand P.; Chaudhry, Rahul; Lesser, Martin; Riegel, Adam C.; Ramoutarpersaud, S.; Rahmani, Navid; Shah, Amar; Papas, Paraskevi Vivian; Dawodu, Toluwani; Charlton, Jessica; Knisely, Jonathan; Lee, Lucille

doi:10.1002/cam4.4037

Cited by 14 publications

(3 citation statements)

References 36 publications

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“…199 The results convincingly demonstrate that a new cancer diagnosis correlated with both CVD morbidity and mortality risk even after adjustment for baseline cardiovascular risk. Furthermore, this CVD risk for several measured outcomes was consistently demonstrated out to 10 years similar to previous evidence from both large observational population studies 198 and smaller targeted studies such as CAROLE (Cardiac-Related Oncologic Late Effects) 200 further strengthening the concept of persistent cancer and cancer therapy-related CVD risk. In keeping with these findings, previously reported evidence from the breast cancer SEER dataset has suggested that cancer may be an risk factor for CVD independent of cancer treatments, such as chemotherapy or radiation therapy.…”

Section: Long-term Outcomes Of Cancer Therapy-related Hypertensionsupporting

confidence: 81%

Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension—Mechanisms and Mitigation

et al. 2023

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Cardiovascular disease and cancer are 2 of the leading causes of death worldwide. Although improvements in outcomes have been noted for both disease entities, the success of cancer therapies has come at the cost of at times very impactful adverse events such as cardiovascular events. Hypertension has been noted as both, a side effect as well as a risk factor for the cardiotoxicity of cancer therapies. Some of these dynamics are in keeping with the role of hypertension as a cardiovascular risk factor not only for heart failure, but also for the development of coronary and cerebrovascular disease, and kidney disease and its association with a higher morbidity and mortality overall. Other aspects such as the molecular mechanisms underlying the amplification of acute and long-term cardiotoxicity risk of anthracyclines and increase in blood pressure with various cancer therapeutics remain to be elucidated. In this review, we cover the latest clinical data regarding the risk of hypertension across a spectrum of novel anticancer therapies as well as the underlying known or postulated pathophysiological mechanisms. Furthermore, we review the acute and long-term implications for the amplification of the development of cardiotoxicity with drugs not commonly associated with hypertension such as anthracyclines. An outline of management strategies, including pharmacological and lifestyle interventions as well as models of care aimed to facilitate early detection and more timely management of hypertension in patients with cancer and survivors concludes this review, which overall aims to improve both cardiovascular and cancer-specific outcomes.

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Section: Long-term Outcomes Of Cancer Therapy-related Hypertensionsupporting

confidence: 81%

Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension—Mechanisms and Mitigation

et al. 2023

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“…The fourth generation consisted of ML-based CVD risk stratifications using the covariates and gold standard. These images can be collected by using MRI, US, and CT ( 141 ) modalities. CUSIP was collected using automated advanced segmentation algorithms based on scale-space as in generation three.…”

Section: Biological Link Between Atherosclerosis and Cardiovascular D...mentioning

confidence: 99%

Cardiovascular disease/stroke risk stratification in deep learning framework: a review

Bhagawati,

Paul,

Agarwal

et al. 2023

Cardiovasc Diagn Ther

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The global mortality rate is known to be the highest due to cardiovascular disease (CVD). Thus, preventive, and early CVD risk identification in a non-invasive manner is vital as healthcare cost is increasing day by day. Conventional methods for risk prediction of CVD lack robustness due to the non-linear relationship between risk factors and cardiovascular events in multi-ethnic cohorts. Few recently proposed machine learning-based risk stratification reviews without deep learning (DL) integration. The proposed study focuses on CVD risk stratification by the use of techniques mainly solo deep learning (SDL) and hybrid deep learning (HDL). Using a PRISMA model, 286 DL-based CVD studies were selected and analyzed. The databases included were Science Direct, IEEE Xplore, PubMed, and Google Scholar. This review is focused on different SDL and HDL architectures, their characteristics, applications, scientific and clinical validation, along with plaque tissue characterization for CVD/stroke risk stratification. Since signal processing methods are also crucial, the study further briefly presented Electrocardiogram (ECG)-based solutions. Finally, the study presented the risk due to bias in AI systems. The risk of bias tools used were (I) ranking method (RBS), (II) region-based map (RBM), (III) radial bias area (RBA), (IV) prediction model risk of bias assessment tool (PROBAST), and (V) risk of bias in non-randomized studies-of interventions (ROBINS-I). The surrogate carotid ultrasound image was mostly used in the UNet-based DL framework for arterial wall segmentation. Ground truth (GT) selection is vital for reducing the risk of bias (RoB) for CVD risk stratification. It was observed that the convolutional neural network (CNN) algorithms were widely used since the feature extraction process was automated. The ensemble-based DL techniques for risk stratification in CVD are likely to supersede the SDL and HDL paradigms. Due to the reliability, high accuracy, and faster execution on dedicated hardware, these DL methods for CVD risk assessment are powerful and promising. The risk of bias in DL methods can be best reduced by considering multicentre data collection and clinical evaluation.

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“…The CAROLE study evaluated the impact of cardiovascular disease in BC survivors previously treated with anthracycline-taxane, 5-fluorouracil, trastuzumab, pertuzumab and RT; the trial showed a high incidence of cardiovascular disease (77.6% and 51.5% in a preclinical and clinical phase respectively) and these percentages also remained higher in patients treated more than 10 years previously [ 71 ].…”

Section: Side Effects Of Systemic Treatmentsmentioning

confidence: 99%

Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm?

Tommasi

Balsano

Corianò

et al. 2022

JCM

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Breast cancer is still a lethal disease and the leading cause of death in women, undermining patients’ survival and quality of life. Modern techniques of surgery and radiotherapy allow for the obtaining of good results in terms of survival, however they cause long-term side effects that persist over time, such as lymphedema and neuropathy. Similarly, the advent of new therapies such as endocrine therapy revolutionized breast cancer outcomes, but side effects are still present even in years of follow-up after cure. Besides the side effects of medical and surgical therapy, breast cancer is a real disruption in patients’ lives considering quality of life-related aspects such as the distortion of body image, the psychological consequences of the diagnosis, and the impact on family dynamics. Therefore, the doctor-patient relationship is central to providing the best support both during treatment and afterwards. The aim of this review is to summarize the consequences of medical and surgical treatment on breast cancer patients and to emphasize the importance of early prevention of side effects to improve patients’ quality of life.

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Cardiotoxicity screening of long‐term, breast cancer survivors—The CAROLE (Cardiac‐Related Oncologic Late Effects) Study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 14 publications

References 36 publications

Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension—Mechanisms and Mitigation

Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension—Mechanisms and Mitigation

Cardiovascular disease/stroke risk stratification in deep learning framework: a review

Long-Term Effects of Breast Cancer Therapy and Care: Calm after the Storm?

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